Bill Overview
Title: Access to Inpatient Rehabilitation Therapy Act of 2022
Description: This bill allows, for purposes of Medicare payment, an intensive rehabilitation therapy program to include other skilled therapeutic modalities besides physical therapy, occupational therapy, speech language pathology services, or orthotic and prosthetic services, as recommended by the treating physician after the patient is admitted. The bill applies after December 31, 2022, or the last day of the COVID-19 public health emergency, whichever is earlier.
Sponsors: Rep. Courtney, Joe [D-CT-2]
Target Audience
Population: People requiring inpatient rehabilitation therapy services
Estimated Size: 9000000
- The bill specifically pertains to those who require inpatient rehabilitation therapy services, meaning individuals with conditions that necessitate intensive rehabilitation are targeted.
- It involves Medicare payment, so it will directly impact individuals who are eligible for or using Medicare, primarily seniors aged 65 and older and certain younger people with disabilities.
- The bill extends the types of therapeutic modalities available in rehabilitation, potentially affecting outcomes for these patients by broadening the scope of covered therapies.
- Given the context of inpatient rehabilitation, this impacts patients recovering from surgeries, strokes, severe injuries, or debilitating health conditions.
- The inclusion of physician-recommended therapies suggests that it could broadly impact all patients under inpatient rehabilitation who might benefit from various therapeutic options beyond traditional ones.
Reasoning
- The budget set for the Access to Inpatient Rehabilitation Therapy Act of 2022 is substantial but has to be measured against a potentially large target population, predominantly Medicare recipients. Additional modalities in rehabilitation therapies can have varying impacts depending on the condition and overall health of the recipient.
- Simulated interviews include a mix of highly impacted individuals and those with lower impacts, acknowledging that not everyone within the target demographic will experience dramatic changes in wellbeing. The program's financial limits might mean that despite a wide target, only select individuals initially experience extensive benefits due to the practical implementation of the policy.
- The long-term wellbeing impact should reflect gradual improvements for those who benefit from expanded therapeutic options, especially over 10 to 20-year horizons in cases of chronic conditions like strokes or severe injuries.
Simulated Interviews
retired teacher (Florida)
Age: 70 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 15/20
Statement of Opinion:
- The expansion of rehabilitation therapies will help me recover faster from surgeries like my hip replacement.
- More therapy options sound like a blessing, I'm hopeful it speeds up my recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
retired engineer (Texas)
Age: 82 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- Having access to more therapies could significantly improve my quality of life post-stroke.
- I'm hopeful for any advancement that aids my speech recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
factory worker (Ohio)
Age: 60 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- Given my injuries, more therapy options can only be a positive.
- I believe the policy will ease some financial burden and help my recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
retired nurse (New York)
Age: 75 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 7/20
Statement of Opinion:
- The possibility of new therapies being covered gives me hope for managing my pain better.
- I'm cautiously optimistic about this change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
retired (California)
Age: 68 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 12/20
Statement of Opinion:
- More diverse therapy options could really support my recovery after surgery.
- I'm particularly interested in less traditional therapies being included.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
retired (Illinois)
Age: 65 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 12/20
Statement of Opinion:
- I'm happy to see more therapies being funded—it gives me more choices.
- This could help alleviate some challenges in my recovery journey.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
retired horticulturist (New Mexico)
Age: 78 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 8/20
Statement of Opinion:
- I welcome any policy that could potentially bring me relief through new therapy modalities.
- It's a forward-thinking move that might help others like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
retired (Massachusetts)
Age: 66 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Integrating more therapies could significantly improve management of my condition.
- I hope this expands to include therapies tailored for respiratory issues.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
retired judge (Virginia)
Age: 90 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 1.0 years
Commonness: 5/20
Statement of Opinion:
- I strongly encourage policies that provide better support systems for our older community.
- I'm somewhat skeptical about implementation but wish it would enhance my exercise regimen.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 4 | 3 |
| Year 3 | 4 | 3 |
| Year 5 | 4 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 4 | 3 |
unemployed due to health (Oregon)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 14/20
Statement of Opinion:
- I think new therapies could offer me alternative and useful ways to manage my pain.
- This policy seems promising for people with chronic conditions like mine.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Cost Estimates
Year 1: $75000000 (Low: $55000000, High: $95000000)
Year 2: $76875000 (Low: $56375000, High: $97525000)
Year 3: $78796875 (Low: $57784375, High: $100660625)
Year 5: $82840117 (Low: $60780077, High: $105847151)
Year 10: $91962232 (Low: $67446330, High: $117457706)
Year 100: $152279602 (Low: $111630558, High: $194243180)
Key Considerations
- The long-term effects of enhanced rehabilitation on healthcare costs beyond the scope of Medicare reimbursement.
- The balance between the immediate increase in Medicare spending and potential cost offsets due to reduced hospital admissions and re-admissions.
- Ensuring equitable access to all expanded therapeutic modalities across different regions and socioeconomic groups.
- Impact on the workload and reimbursement structures for rehabilitation professionals.