Medicare changes could deny rehabilitation care

I am writing to bring attention to an urgent health care issue that affects residents across Eastern Iowa — the growing trend of Medicare Advantage denials for inpatient rehabilitation facility (IRF) care. As discussions continue about potentially shifting more Medicare recipients into Medicare Advantage plans, I urge readers to consider the impact this would have on access to critical rehabilitation services and to take action by contacting their legislators.

Currently, Medicare Advantage enrollees face higher rates of denials and delays for IRF care, forcing many patients into lower levels of rehabilitation that do not meet their medical needs. This often results in delayed recovery, preventable hospital readmissions, and increased long-term health care costs. Traditional Medicare provides broader access to inpatient rehabilitation, ensuring that medical decisions are made by physicians rather than insurance companies focused on cost-cutting.

Take "John," a 68-year-old stroke survivor from rural Iowa. His doctor recommended inpatient rehabilitation, but his Medicare Advantage plan denied the request, stating he would be better served in a skilled nursing facility. With only limited therapy there, "John’s" progress stalled. Within a month, he was readmitted to the hospital — a preventable setback that cost both him and the health care system.

John’s story is not unique. Families across southeast Iowa are facing similar struggles as rehabilitation access becomes increasingly restricted.

If more Iowans are moved from traditional Medicare to Medicare Advantage, patients recovering from strokes, brain injuries, and other serious conditions will face unnecessary hurdles in accessing the rehabilitation care they need. Many individuals may not realize this issue until they or a loved one requires inpatient rehabilitation — only to be denied the care they were promised.

This is not just a rural or small-town problem — it affects hospitals and rehabilitation facilities across the state, including in Cedar Rapids, Iowa City, and beyond. If Medicare Advantage plans continue denying appropriate rehabilitation care, more Iowans will be forced into inadequate alternatives, increasing strain on families and the health care system.

I urge all readers to contact their state and federal legislators and ask:

• Do you support maintaining access to inpatient rehabilitation through traditional Medicare?

• Will you hold Medicare Advantage plans accountable for unnecessary denials that harm patients?

• What steps are you taking to ensure that Medicare beneficiaries can receive the care they need without bureaucratic barriers?

The decisions made about Medicare today will affect our families, friends, and neighbors tomorrow. If we do nothing, more Iowans will suffer needlessly. The time to act is now. Please call, email, or write your legislators and make your voice heard before it’s too late.

Dr. Christopher R. Crossett, DNP, MBA, MSN, RN, CRRN, is a board-certified rehabilitation registered nurse with extensive experience in post-acute care. Crossett lives in Cedar Rapids.