2018 Congressional Elections

Primary elections have come to an end, but your Congressional candidates are gearing up for an intense mid-term election season and are keenly aware of the importance of visiting with and listening to the concerns of their constituents. AMRPA encourages its members to use the coming weeks to educate candidates running for Congressional office about the value of care provided in inpatient rehabilitation hospitals and units by offering them a tour of your hospital, meeting with them at their offices, or visiting with them during town hall or community meetings.

We greatly appreciate your time and willingness to help AMRPA communicate the importance of access and protection for patients that need medically necessary rehabilitative care.

Scheduling a Meeting with the Candidates Seeking Election

  • Use the links below to locate their campaign headquarters and contact information.
  • Call, email, or submit an online contact form requesting a meeting with the candidate or extending an invitation to your hospital or unit.

If one of the candidates is an incumbent member of Congress running for reelection, you may also follow these steps to set up a meeting:

  • Call the U.S. Capitol Switchboard at (202) 224-3121 and ask for your Senators’ and Representative's office or access their contact information online at www.house.gov and www.senate.gov.
  • Ask the office for instructions regarding the preferred way to submit a request for a meeting or an invitation to tour your hospital or unit in the District/State. Congressional offices handle their District scheduling requests differently. The Washington, D.C. office may arrange for the meeting directly or may refer you to their Congressional District office to set up the visit.

For more information on your current federal representatives, please visit the following websites:

Once you have a meeting or tour scheduled, please inform Kendall Hussey (khussey@akingump.com / 202-416-5207) so we can track AMRPA’s outreach efforts.

 

In preparation for meeting with the candidates, below please find an AMRPA excerpt discussing the value of inpatient medical rehabilitation:

Inpatient Rehabilitation Hospitals and Units Provide Critically Important Care to People Overcoming Challenges from Injuries, Illnesses, and Conditions

What is Inpatient Medical Rehabilitation?

Inpatient medical rehabilitation is a critical component of the health care delivery system. Medical rehabilitation refers to evaluation, diagnosis, treatment, and procedures that seek to minimize physical and cognitive impairments, prevent institutionalization and re-hospitalization, and optimize functional ability, thereby reducing the impact of a disabling condition on the quality and productivity of a patient’s life.[1]

The goals and purpose of inpatient medical rehabilitation have been described in various ways with the primary emphasis on restoring a person’s ability to function in a normal manner. Medical rehabilitation may begin during a patient’s stay in an acute care hospital in order to help the patient move, walk, talk, dress, and/or eat independently without assistance.  Medical rehabilitation prevents unnecessary medical costs in the long-term and allows patients to return to the most important people and activities in their lives. For the majority of clinicians and advocates in the medical rehabilitation field, the preferred term for patients is “persons with disabling conditions” (PWD).  The emphasis is placed on an individual patient’s ability to function and not on his/her disabling condition.

Conditions Necessitating Inpatient Medical Rehabilitation

Unlike acute care hospitals, which focus on a patient’s diagnosis in developing a care plan, inpatient rehabilitation hospitals and units (IRH/Us) consider an individual’s function, other patient characteristics, and environmental factors in determining the appropriate care for a patient. Conditions commonly treated in medical rehabilitation hospitals include stroke, brain and spinal cord injuries, neurological diseases, major musculoskeletal disorders, cardiopulmonary disorders, and transplantation. IRH/Us are also referred to as inpatient rehabilitation facilities or “IRFs” by the Centers for Medicare and Medicaid Services (CMS).

Characteristics of a Rehabilitation Patient

Patients treated in inpatient rehabilitation hospitals and rehabilitation units of acute care hospitals are among the most vulnerable in American society. Almost all patients admitted to IRH/Us have recent adverse events such as hospitalization, sudden injury, illness, trauma, or pain. 

The Mission of Inpatient Rehabilitation Hospitals/Units

IRH/Us provide rehabilitation to patients working to overcome some of the most challenging injuries and conditions. IRH/Us work daily with beneficiaries of Medicare, Medicaid, and private insurance to maximize their health, functional skills, independence, and participation in society so they are able to return to home, work, or an active retirement.

Development of the Medical Rehabilitation Field

The medical rehabilitation field was developed early in the 20th century by visionaries who believed that there was more to health care than simply diagnosing and medically treating patients with serious permanent impairments. They believed that such patients could, with appropriate rehabilitation, return to active and productive lives and contribute to their family, community, and the economic life of the nation. Over the years, the work of physician-directed, hospital-based interdisciplinary teams comprised of rehabilitation physicians and nurses, as well as physical, occupational, and speech language therapists, who are devoted to the principles of rehabilitation evolved into the field of medical rehabilitation as we know it today.

In reaction to the implementation of the Inpatient Prospective Payment System (IPPS) in 1983, many acute care hospitals responded to various incentives therein by discharging patients more quickly and with greater medical complexity, frequently referred to as “sooner or sicker.” Due to the growing volume of patients who needed care subsequent to their acute care stay, the number of rehabilitation providers began to grow in order to treat the number of patients needing medical rehabilitation services. The predecessor organization to the American Medical Rehabilitation Providers Association (AMRPA) completed a survey of IRH/Us in 1984 and found there were 308 rehabilitation units and 49 rehabilitation hospitals. In 2018, there are 896 rehabilitation units and 282 rehabilitation hospitals.

Inpatient Rehabilitation Hospital/Unit Payers

Approximately 60 percent of IRH/U patient care is compensated through Medicare Part A under the traditional Medicare fee-for-service payment (FFS) model referred to as the Medicare Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). IRH/Us additionally treat patients whose care is paid for by Medicaid or commercial insurers.  A growing number of IRH/Us receive payment through Medicare managed care plans. Several IRH/Us participate in alternative payment models such as the Bundled Payments for Care Improvement (BPCI) initiative and accountable care organizations (ACOs).

Since implementation of the IRF PPS in 2002, IRH/Us have been required to complete the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI). The IRF-PAI is an assessment tool that collects highly detailed information about a patient’s diagnosis, co-morbidities and complexities, length of stay, motor and cognitive functioning, as well as discharge destination and initial referring site.  The IRF-PAI provides additional patient data that would be helpful in characterizing and understanding patient outcomes and burden of care, IRH/Us’ readmissions patterns, patient characteristics, and developing risk adjustment analyses. IRH/Us report their patient data to CMS.

 

[1] There are varying definitions of rehabilitation. The World Health Organization describes rehabilitation as “instrumental in enabling people with limitations in functioning to remain in or return to their home or community, live independently, and participate in education, the labour market and civic life.” See http://www.who.int/disabilities/care/en/.  The National Association of Insurance Commissioners defines rehabilitation as “health care services that help a person keep, get back or improve skills and functioning for daily living that have been lost or impaired because a person was sick, hurt or disabled.”  The Department of Health and Human Services mandates that all state health exchange insurance plans include within their essential health benefits rehabilitative and habilitative services. HHS defines rehabilitative and habilitative services as “services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills.” See https://www.healthcare.gov/blog/10-health-care-benefits-covered-in-the-health-insurance-marketplace/.

 

For election results by state please visit: https://www.politico.com/election-results/2018/

For more voting information, and to find out if you are registered, visit: www.usa.gov/voting.

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