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Protect Patient Access to the Right Care Setting, Not the Cheapest | Commentary

On the whole, rehabilitation hospital patients were eight percent more likely to stay alive than nursing home patients over a two-year period. Those with brain injuries and strokes were 16 percent and 14 percent, respectively, more likely to survive after having been cared for in a rehabilitation hospital. In addition, rehabilitation hospital patients had five percent fewer hospital readmissions and five percent fewer emergency room visits per year than those who were treated in nursing homes.

These superior clinical outcomes were achieved at an additional cost to Medicare of only $12.59 a day. In fact, timely, intensive and coordinated rehabilitation provided in a rehabilitation hospital or unit decreases unnecessary long-term dependency costs to the federal government. It returns Medicare patients to their homes and communities, and decreases the need to shift costs to the states by relying on Medicaid as the payer of last resort for unnecessary long-term nursing home care. It is also the linchpin to reducing costly and needless hospital readmissions for those with a wide range of debilitating conditions.

Congress should consider this new study when next faced with proposals that would decrease short-term Medicare expenditures by simply shifting costs to patients, states and other provider settings. It should avoid proposals that will lead to a reduction in access to intensive, coordinated rehabilitation services or that create barriers or channel patients into settings that do not meet an individual’s medical and rehabilitation needs. Instead, Congress should ensure that patients get the right treatment in the right setting for the right duration of time.

Achieving significant federal savings on the backs of people with disabilities and some of our most vulnerable Medicare beneficiaries is not the path to success.

Susan Stout is interim president & CEO of the Amputee Coalition, Susan H. Connors is president & CEO of the Brain Injury Association and Alexandra

Bennewith is vice president of government relations, United Spinal Association.

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