Preserve access to rehabilitation

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As a stroke survivor, I know how important rehabilitation is when it comes to recovering from a major trauma. I credit returning to the Senate to nearly a year of intense, grueling physical and occupational therapy. It is now a major priority for me to help others who suffer from major health events to get back to work through rehab, and I believe access to specialized care at a rehabilitation hospital holds the key to meeting this goal.

However, the current framework for those who need access to specialized rehabilitation — those not old enough to be covered by Medicare and those who do not fit within a list of specific diagnoses — is under threat. A little-known, technical Medicare law called the “60 percent rule” limits access to specialized rehabilitation to those who don’t have Medicare and those who don’t have diagnoses like stroke, traumatic brain injury or joint replacement.

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Congress is considering changing the 60 percent rule to require hospitals to treat 75 percent of its patients under the Medicare and specific diagnosis requirement, leaving room for hospitals to take only a quarter of patients under no prerequisite. This would be a mistake. Under the proposed change, some hospitals will close, and children managing cancer treatments or adults needing rehab after organ transplants will be turned away. A person who has survived a catastrophic infection or a complicated hospital stay but does not have the basic strength or endurance for mobility would also be turned away. 

Government and private studies overwhelmingly demonstrate the positive impacts rehabilitation hospitals provide to patients compared to other types of post-acute care. These studies also show long-term cost savings and benefits for taxpayers. Patients at rehabilitation hospitals leave with stronger independent living skills, stay in the hospital half the time, and are discharged directly home more often.

Due to the overwhelmingly positive return on rehabilitation, advisory committees like MedPac and the Centers for Medicare and Medicaid Services recommend the 60 percent rule remain unchanged, and they are right. It doesn’t make sense to change the rule when the current framework helps individuals of all ages return to their productive place in society with the right remedies. We shouldn’t be holding patients back with options for lesser care, or worse, no options at all. Over the long run, changing the rule will only push people into reduced care, driving up costs and preventing them from returning to work faster.

Prior to suffering a stroke, I, like many Americans, never thought twice about the availability of a rehabilitation hospital. Rejecting efforts to change this rule will ensure more families can continue to access the kind of quality rehabilitation they deserve.

Kirk is the junior senator from Illinois, serving since 2010. He sits on the Appropriations; Banking, Housing and Urban Affairs; and the Health, Education, Labor and Pensions committees, as well as the Special Committee on Aging.