The White House just released a spending proposal for the road ahead, and the skilled care sector is not happy. Not happy at all.
Despite its $4.4 trillion price tag, the budget would incorporate block grants to cover Medicaid-related services. Can’t imagine why providers would not like a plan that cuts off funding once an arbitrary amount is spent. You have a building full of residents who still need care? Well, let my little lawyer friend introduce you to a concept called pro bono.
Then there’s the item calling for Medicare post-acute payment increases to get dialed down between 2019 and 2023.
Finally, we have the money shot: the Department of Health and Human Services would move to a unified post-acute care payment system in 2023 that pays the same rate for patient care, no matter the setting.
All in all, it’s not too hard to see why this proposal is about as welcome as a bacon platter at a bar mitzvah.
It should be noted that this is a plan, nothing more. Not a single bill has been introduced in Congress that would make any of these things happen, yet. But it’s probably a safe bet some lawmaker soon will take the hint.
Although these changes may tend to make nursing home administrators tense and morose, there actually may be an opportunity here for senior living operators. And it has to do with the last item. The one about the same pay for the same service, regardless.
For if you can deliver post-acute care at a lower cost than the skilled care joint down the street, you just might find yourself swimming in a very nice new revenue stream.
Of course, there’s that little matter of actually delivering lower-cost care and documenting that it’s being done safely.
Not that this feat will get you completely out of the woods. For by jumping into the post-acute arena, you also are going to undermine an argument your peers have been making for decades. Namely, that federal rules should not be put upon senior living because it’s a different kind of business.
For when you have a building full of medically complex people who just came out of surgery, that can be a pretty tough argument to make. At least with a straight face.
John O’Connor is editorial director of McKnight’s Senior Living. Email him at email@example.com.