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MailTribune.com
  • All health care is local, and Medicare rules have local impacts

  • Washington, D.C., is 2,900 miles away from the Rogue Valley, and at times it might as well be on another planet, and the elected officials in the capitol might as well be speaking in an alien tongue. Yet, ultimately, the hot air of Washington can end up being a storm in Oregon.
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  • Washington, D.C., is 2,900 miles away from the Rogue Valley, and at times it might as well be on another planet, and the elected officials in the capitol might as well be speaking in an alien tongue. Yet, ultimately, the hot air of Washington can end up being a storm in Oregon.
    For 17 years Medicare has been dealing with some impractical legislation that attempted to control costs by setting price controls on how much physicians would be paid. The unintended consequence was that many physicians began seeing fewer Medicare patients. So, to fix the problem, periodically Congress would pass an exception to the price controls while they left the permanent solution for another day. Congress is now considering a permanent fix, but also has to determine how to pay for it.
    That brings us back to Oregon, to the Rogue Valley. One of the areas being targeted for cuts is the special Medicare benefit for inpatient medical rehabilitation.
    Inpatient rehabilitation occurs in specially certified hospitals that must meet stringent staffing, therapy and admission criteria. Common diagnoses are stroke, multiple trauma, spinal cord injuries and such. Our hospitals provide frequent and close supervision by a physician who specializes in rehabilitation medicine, close coordination of all of the disciplines, specialty trained nurses, and three hours of therapy per day with physical therapists, occupational therapists, speech/language pathologists and other rehabilitation specialists.
    All of this is expensive, but the result is gratifying. Most inpatient hospital rehabilitation patients leave for home or a community environment, and most continue to improve their independence with continued therapy. As we are fond of saying, the hospital saves lives, but rehabilitation helps make lives worth living.
    The most threatening proposals for the "doc fix" range from cuts to Medicare payment rates for rehabilitation hospitals, to treating every type of facility that provides some level of rehabilitation services the same. Nursing homes would be paid the same as a rehabilitation hospital even though they provide a much less intensive level of treatment.
    Inpatient medical rehabilitation hospitals provide a significant return on investment in terms of optimizing the independence of patients. With the burden of care reduced, it's a win for the patients, their families, and society. But these proposed changes would chip away at our ability to keep our rehabilitation hospitals' doors open. The numbers of beds that are available to patients could be greatly reduced. Families could be faced with sending patients to other settings outside of the Rogue Valley rather than keeping them close to home, family, and caregivers.
    We encourage you to contact your members of Congress to ask them to protect funding for inpatient rehabilitation hospitals and preserve patient access to these critical treatments and services. The following number will automatically connect you with the offices of your congressman and two senators: 888-255-1702. Urge Congress to make decisions that ensure the right patients get the right treatment in the right setting. That's our priority, and it should be Congress' too.
    Bob Perlson is director of rehabilitation services for Asante Rogue Regional Medical Center.
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