Complex rehab cuts reach deep

YARMOUTH, Maine - Complex rehab stakeholders worry that shrinking Medicare reimbursement will have an impact on more than just the bottom lines of providers.

As providers cut back their expenses in the face of reimbursement cuts and coverage policy limitations, they set off a chain reaction that could result in less research and development, and fewer technological advancements, stakeholders worry.

“There's a small population of people that require complex rehab,” said Don Clayback, executive director of NCART. “So for manufacturers to continue to invest and provide products for this market segment, they need to know that there is going to be buyers for that product.”

Most recently, complex rehab providers have had to absorb competitive bidding pricing for accessories for complex power wheelchairs starting Jan. 1.

That chain reaction isn't limited to innovation, either. Organizations that rely on donations, such as the Clinician Task Force, are under pressure, too.

“The change for accessories has significantly reduced financial support, as people plan for the impact of this law,” said Laura Cohen, executive director of the Clinician Task Force. “Basically, if we can't raise funds we will no longer exist—or however much funds we can raise, will be as much support as we can provide.”

NRRTS hastaken pre-emptive steps to make the dollars it receives from sponsorships go further. For example, NRRTS, which previously rented office space, has embraced telecommuting.

“When I took over as executive director, we looked at a lot of ways to cut overhead, because we didn't want to raise fees and we wanted to continue to provide webinars at no cost to members,” said Weesie Walker, executive director of NRRTS.

Fortunately, there is one area where stakeholders continue to see a healthy amount of investment: advocacy.

“We need to make sure we maintain that, because if you start cutting back on advocacy as payment reductions increase, it's a self-defeating cycle,” said Clayback.