New Jersey's rehabilitation hospitals are lobbying to prevent congressional cuts that could steer patients away from dedicated inpatient recovery centers.
In attempting to address a shortfall in Medicare funding, Congress in December authorized a short-term spending fix in the rate used to pay doctors. That expired March 31.
The new round of funding could have strings tied to spending reforms.
One identified target of cuts is inpatient rehabilitation centers. Medicare now requires at least
60 percent of a rehabilitation center's patients to meet one of 13 serious health diagnoses for the center to receive reimbursement.
U.S. Rep. Frank LoBiondo,
R-2nd, sponsored legislation in 2008 setting that threshold at
60 percent to keep options open for more patients after they leave a hospital.
But a new congressional proposal would push that threshold back up to 75 percent, which would disqualify many patients whose medical situations call for intensive rehabilitation, said Richard Kathrins, of Toms River, president and CEO of Bacharach Institute for Rehabilitation in Egg Harbor Township.
"Rehabilitation is only optional if you don't need it," Kathrins said.
Bacharach and several other New Jersey rehabilitation centers are lobbying the state's congressional delegation to defend their Medicare allocation and other budgetary tinkering.
"The one that could affect rehabilitation hospitals and nursing homes is the proposal to bundle payments," Kathrins said.
Taxpayers spend about $6.5 billion per year on the 371,000 patients who are treated at inpatient rehabilitation centers, according to the House Ways and Means Committee.
This is the equivalent of $17,520 per person.
But 14 times as many patients are treated each year at skilled nursing facilities or in a home-health setting, which combined costs Medicare nearly $50 billion or just $9,803 per patient.
Kathrins said it would be a mistake to prevent patients who need intensive rehabilitation from receiving the kind of specialized treatment provided by centers such as Bacharach.
"We're hoping they don't restrict access to care for beneficiaries. It's the wrong approach," he said.
Meanwhile, a study this year by the American Medical Rehabilitation Providers Association found that patients treated at inpatient rehab centers had better health outcomes in the long term than those who went straight to nursing homes.
The group is organizing a letter-writing campaign to urge Congress to preserve funding for dedicated rehabilitation centers.
Bacharach spokeswoman Mary Joyce Perskie said inpatient rehabilitation offers a level of care that can't be duplicated at a nursing home.
The center in Galloway Township has 80 rehabilitation beds, including 60 dedicated to acute-care patients.
"It's well documented that people who go to nursing homes for serious conditions die sooner than those who go to a level-1 rehab center. It's grim stuff," she said. "Go to a nursing home after a stroke, you won't make gains as if you went to a level-1 rehab center."
Bacharach has enlisted the help of its employees to get the word out about the proposed federal funding changes, setting up a website to help employees who might live outside the 2nd Congressional District find their own representative.
Perskie said Bacharach employees take great pride in the center's reputation.
"We would not be celebrating our 90th year if we didn't do a phenomenal job. We get referrals from the most prestigious hospitals in Philadelphia and New York," she said. "We measure our outcomes daily, monthly and weekly. We get great outcomes. But it's costly, time consuming, interdisciplinary care. There are no shortcuts."
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