Today’s blog comes to us from Beth Bacher, Encompass Health Valley of the Sun Rehabilitation Hospital CEO. Here she shares her thoughts on the success, challenges and the future of healthcare in Arizona. Once you’ve had a chance to read it, we’d love to hear your thoughts. Generating meaningful conversations around the health issues facing us here in Arizona is another way we are working to make our state the Healthiest State in the Nation!
QUESTION: What are the two biggest hurdles to providing care?
- Insurance denials on appropriate ACUTE rehabilitation candidates
- Patients being provided accurate/comprehensive choices for post-acute care options when they are getting ready to discharge from an acute hospital setting.
QUESTION: What are the greatest health needs in your community?
I see two areas of great need: In our community, we have several hospitals that have recently been certified as Level 1 trauma centers. These hospitals are seeing an increase in trauma related injuries and deaths. Last year AZ treated approximately 52,000 trauma patients. It is critical that these patients receive high quality rehab post their acute hospital stay in order to maximize their rehabilitation potential, get them back a higher level of independence and reduce the potential for long-term physical pain and suffering which is a significant financial burden on the state. The other area of need are the patients who end up in observation status in the ER. Frequently, these are patients who have had multiple ER visits and they are weak and debilitated. Because they are not “admitted” have limited options post their hospital stay. Encompass Health has done education with ED and OBS physicians and case managers to discuss the role that ACUTE rehab can have in assisting those patients to stabilize medically and physically, and to stop the cycle of repeat hospital visits. These repeat admissions back and forth to a hospital are detrimental to the well-being of the patient. It is costly, and often the underlying issues are inadequately addressed. ACUTE Rehabilitation can have a positive impact in those patients’ lives and reduce the long-term costs of multiple hospital visits. An admission to our hospital level is not measured as a readmission.
QUESTION: What is your facility’s greatest recent success?
We have many successes, but two areas I’d like to highlight are our success with Stroke patients and our success with Amputee patients. In 2018, our patients admitted with a Stroke diagnosis have exceeded the national average Functional Independence Measure (FIM) gains. We are treating more stroke patients in the acute rehab setting. Per AHA guidelines, stroke patients who qualify for inpatient rehabilitation should receive those services in an acute rehab setting versus a skilled nursing setting to optimize their outcomes (see the AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery published in May of 2016 Downloaded from http://stroke.ahajournals.org<http://stroke.ahajournals.org/>). Another area that we have great success is with Amputee patients. We have an amazing amputee community at our hospital that also exceeds the national average in FIM gain. We provide great wrap around support for amputees who have been in our in-patient setting as they transition into our outpatient setting. Our clinicians connect the patients with the right support services and equipment to not only get them started off successfully on their journey as an amputee, but to set them up for long-term success.
QUESTION: What keeps you up at night?
What I am most concerned about is the notion of adequate coverage. People are swayed by the large insurance companies to purchase an “affordable” healthcare option believing they will have full coverage and receive the care they need when they need it. Unfortunately, they often find out after a traumatic life-changing event that the plan they have purchased will not provide them the right level of care to optimize their outcomes and get them back to independence as soon as possible. Unfortunately, we see denials of appropriate rehabilitation candidates for an acute rehab setting on a daily basis in favor of lower level rehab options that cannot provide the intensity level or medical management that an acute rehab setting can.
QUESTION: When you think about the future, what are you most hopeful for?
When I think about the future of healthcare the thing I am most hopeful about is community education. We are a diverse community with multiple education and wellness resources available. Families can be better advocates for their loved ones as they research care options. Encompass is an advocate on educating the community about the choices they have regarding their healthcare and wellness. We do many free educational presentations to the community. We believe an educated community can make better choices for themselves and their loved ones. An educated consumer is an empowered consumer.