Inpatient Rehab Outlook with AMRPA: Review Choice Demo Roll-Out, Landscape for MA Utilization, Case Mix Calculations, Early Discharge Penalty
Inpatient rehabilitation facilities (IRFs) have faced regulatory scrutiny in recent years, owing to a wide margin differential between freestanding and hospital-based units, as well as improper claims. The latter resulted in the mandatory Review Choice Demonstration Program, which rolled out in Alabama in August 2023, and is slated to expand to Pennsylvania, Texas, and California.
As 2025 rulemaking approaches, there are continuing questions around how CMS will treat the sector in the short-term and beyond. With an eye towards the 2025 proposed rule and broader industry priorities, Marwood hosted a call with Kate Beller, EVP of Policy Development and Government Relations at the American Medical Rehabilitation Providers Association.
- Takeaways from IRF RCD roll-out; read-through for states next in queue (e.g., PA, TX, CA)
- Landscape for Medicare Advantage in IRF markets
- Policies ripe for reform and potential impacts (e.g., case mix calculation, early discharge penalty); MedPAC’s forthcoming Report to Congress
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Kate Beller serves as the American Medical Rehabilitation Providers Association’s Executive Vice President for Policy Development and Government Relations. In this capacity, she identifies current and emerging policy issues affecting the rehabilitation industry. Prior to joining AMRPA, Ms. Beller served as a principal at a healthcare-focused consulting/lobbying firm, where she developed and helped lead the legislative and regulatory strategies for post-acute care providers and other entities across the health policy spectrum. She also held positions at AARP and the Center for Excellence in Assisted Living, working on long-term care and post-acute care payment and payment access issues. She received her Juris Doctorate at Georgetown University Law Center and her undergraduate degree at Duke University.