Do you get the feeling that the national movement to reform healthcare is bypassing inpatient rehabilitation facilities (IRFs)? Now, I understand that we are but a small part of the national healthcare budget, and perhaps a smaller part of the problem as seen through the eyes of policy makers. But so far, IRFs rarely enter into the discussion about change. To date, IRFs are excluded from considerations for meaningful use, rarely mentioned in the Affordable Care Act, don’t appear on Health Care Compare and have yet to be calculated into an Accountable Care Organization methodology. Some of our most prudent colleagues argue it is only a matter of time before the IRF is pulled into the deliberation.
This past week, an asteroid the size of your house passed within 7,500 miles of the earth, close enough to change its orbit before being flung out into space. No one saw it coming except the few astronomers who discovered it five days earlier. The evening news reported we were really never in any danger. And in the wake of this potentially disastrous intergalactic inflection, not much has changed and few noticed.
The IRF’s response to healthcare reform has been similar. “No sense getting all worked up for something you have no control over, if it happens it happens.” Do we assume whatever is good for primary care and acute hospitals is good for rehab?
I know our friends at AMRPA are diligent and have their fingers on the pulse of reform with foresight and influence into legislated and regulatory matters. The industry is grateful for the work done and insight gained, particularly for early warning and alerts to a potential CMS crisis or RACtiod collision. But when it comes to managing the change of reform, many IRFs are looking in the rear view mirror.
Behavioral change or change management is not a priory for many IRF C-level executives and until the asteroid hits, there is nothing different to be done; unless of course, there is significant reason to change direction.
That reason may come with the awareness that the IRF business as usual is no longer affordable and survival requires new knowledge and skill. Acquiring the intelligence tools to improve effectiveness and efficiency is sound preparation for reform. Asteroids are a lesser threat.