I want to tell you about something I lost and then recoveredand the real difference that people can make by working together.
When I was young, I was a firm believer in making a difference by getting involved in the political process. It was the late 60s and early 70s, and people were actively participating in the events of the day. Civil rights, the Vietnam War, gender equalitywe were making a difference.
Somewhere along the way, Im not sure when, I lost itthat is, lost the belief that by getting involved in the political process, we could make a difference. However, recent events involving federal regulations showed me the difference we can and must make.
In July 2004, the CMS amended what is commonly referred to as the 75% rulea regulation governing the kinds of patients that facilities can admit in order to qualify as inpatient rehabilitative providers. Although the rationale for changes to the rule seemed logical at the time, nobody could envision the devastating impact it would have on patients access to care. The number of Medicare patients receiving care in inpatient rehabilitation facilities, or IRFs, declined by more than 20% in the first two years compared with the 12 months immediately preceding the revised rules implementation.
Behind those grim statistics were thousands of real peoplemost of them elderlywho needed the specialized rehabilitative care that only IRFs can provide but who were denied access to this care. For many of them, this was the difference between the chance to resume normal, independent lives and the prospect of leading diminished lives in institutional settings.
Thats when I again found that we at HealthSouth Corp., along with other providers of inpatient rehabilitative care, had to take a stand and try to change the 75% rule. If we didnt, who would?
We began our efforts in mid-2005. Our governmental affairs staff and lobbyists at that time initially advised a cautious, Dont rock the boat approach. They warned us that if we tried to engage in a grass-roots campaignmy original impulse given the lessons of my youththe members of the congressional committees that had jurisdiction would take it as an affront to their prerogatives. We tried this strategy, with disappointing results; we got a one-year moratorium.
With a lesson learned, I was convinced the only way to affect permanent change was to get real people involved through a comprehensive grass-roots campaign. With leadership from the American Hospital Association, the Federation of American Hospitals and the American Medical Rehabilitation Providers Association, our industry educated Congress about the injustices of the 75% ruleand that its rollout was having a far different effect than what was perhaps intended. We received strong support for changing the rule from congressional leaders from both sides of the aisle, with 240 House members and 62 senators co-sponsoring legislation to permanently fix the rule.
Complementing the industry effort was HealthSouths comprehensive grass-roots strategy. We assigned primary advocacy responsibility to a senior member of each hospitals management team and held weekly conference calls with them. We invited members of Congress to our hospitals for tours and meetings with patients, family members and physicians. We participated in industry-sponsored fly-ins to Washington where we visited congressional leaders in their offices to explain the plight of patients who were unable to receive necessary rehabilitative care. We got the attention of local media, which resulted in editorials and television reports endorsing a change to the rule.
On Dec. 29, 2007, President Bush signed into law a measure that, among other things, included a provision permanently lowering the threshold for compliance to 60%.
Almost three years in the making, against incredible odds, with a lot of people saying it couldnt be done, we made it happen: We were able to change an existing government regulation for the benefit of thousands of patients across the country. Margaret Mead, the famous anthropologist, may have said it best: Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.