A recent survey of more than 110 brain injury rehabilitation providers across the state commissioned by the Michigan Brain Injury Provider Council (MBIPC) indicates that nearly all are planning for the worst, including going out of business, if legislators don’t pass a technical fix that enables post-acute facilities to continue providing care.
The statewide survey found that facilities will be forced to lay off thousands of workers, discontinue catastrophic care for thousands of auto accident patients and potentially go out of business, if House Bill 4486 isn’t passed well before July 1.
“Nearly nine in ten post-acute care facilities have little or no confidence that they will be staying in business after July 1 of this year if House Bill 4486 is not passed. It behooves us to listen to those on the front lines, providing care for the most vulnerable. They have first-hand knowledge of the day-to-day realities and the urgent need for this fix. Lansing bureaucrats and special interests won’t find more reliable data than that,” said MBIPC President Tom Judd. “We are hurtling toward a crisis of catastrophic proportions for Michigan caregivers and the post-acute patients they serve.”
The bill contains a technical legislative fix to the state’s auto insurance law. Under the 2019 auto insurance reform, health care services that do not have a corresponding “Medicare code”—which includes most services provided by brain injury rehabilitation centers—would be required to slash reimbursements by 45%.
The statewide survey of providers reveals the following key findings:
- Nearly nine in ten post-acute care facilities have little or no confidence in staying in business under the fee schedule outlined in Michigan’s Public Act 21: Eighty-six percent (86%) of post-acute care facilities have either no confidence at all (65%) or very little confidence (21%) that they can operate their business at a sustainable level under the new auto no-fault fee schedule in its current form. Another 21% are only slightly confident.
- Thousands of patients will potentially lose care across the state: Nearly eight in ten of all respondents (79%) expect a decrease in the number of auto no-fault patients for which their facility can provide care, if the fee schedule goes forward unchanged. When asked to quantify how many patients will potentially lose care, the average response was between 31 to 40 expected patients lost per facility; meaning that between 4,800 and 6,200 patients across the state will potentially lose care from these facilities alone.
- Nearly four in ten (38%) expect that care to be lost immediately, while more than eight in ten (85%) expect it to be lost within the first few months after the new fee schedule goes into effect.
- The facilities surveyed currently provide care for between 6,350 and 7,800 post-acute care patients across Michigan.
- Thousands of jobs will potentially be lost across the state: Nine in ten facilities (90%) expect to decrease their number of employees if the fee schedule goes forward unchanged. When asked to quantify how many jobs will be lost, the average response was between 21 and 30 expected jobs lost per facility; meaning that between 3,250 to 4,650 jobs will potentially be lost across all facilities in the state. This estimate does not account for indirect jobs lost.
- More than four in ten (45%) expect to lose those jobs immediately, while more than eight in ten (85%) expect those job losses within the first few months after the new fee schedule goes into effect.
- The facilities surveyed currently provide jobs for between 6,350 and 7,800 post-acute care practitioners across Michigan.
The survey was commissioned by MBIPC and conducted by ROI Insight, a Michigan-based market research company.
“The most vulnerable individuals with the most complex needs will need to be transitioned out of specialized residential programs, beginning well before July 1,” Judd said. “It’s unclear where these individuals will go to receive the specialized care, supervision, and treatment they need and deserve – not to mention the potential job losses we are facing. In addition, this survey does not capture the disruption facing families providing care to their loved ones inside their homes.”
Last week, HB 4486 was introduced by Rep. Doug Wozniak of Shelby Township, proposing limits on how much post-acute care providers can charge while enabling patients to access care and providers to remain in business.
“This proposed legislative solution to the unintended consequences of Public Act 21 is a simple fix and narrowly focused on meeting the intent of the law,” Judd said. “It does not add cost to the system.”