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Campaign 2012 boosted importance, value of nursing home care in public policy dialogue

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Alan Rosenbloom
Alan Rosenbloom

With a prominent focus on seniors' care and its financing, one significant benefit coming out of the 2012 campaign for the U.S. Skilled Nursing Facility (SNF) sector is that the general issues terrain served to both boost the significance of nursing home care in the public policy dialogue, and help establish a framework enabling Congress to better assess individual providers' ability to offer the best value for various post-acute procedures, at the lowest cost to taxpayers.
 

Despite the customary complaints about negativity and the avalanche of TV ads, the 2012 campaign was unusually substantive from the standpoint of the entitlement reform discussion because both sides were required to make their best arguments about how we as a nation will protect seniors' Medicare funding in an era of unprecedented fiscal chaos.

Not only was the importance of U.S. seniors' nursing home care specifically mentioned at both parties' political conventions, and in a variety of TV ads, but seniors' Medicare and Medicaid funding issues in general -- and the broader problems for seniors caused by SNF cuts in particular -- were part of the discussion. Debunking the fallacy that Medicare cuts ‘only' to nursing home providers will not also negatively impact beneficiaries themselves remains a priority.
 
Our members made major headway this election cycle with members of both parties by taking this issue head-on with U.S. Senate and House candidates this summer during a vigorous facility tour program. This local engagement will now continue in the run-up to the 113th Congress.
 
The issue of SNF cuts gained still more prominence when Douglas Holtz-Eakin and Kenneth Thorpe of the bipartisan Partnership for the Future of Medicare penned an October Politico oped noting it is “disingenuous to suggest that [nursing home] provider cuts will not impact beneficiaries.” Holtz-Eakin and Thorpe also noted, correctly, that a recent 1.8% Medicare payment update from the Centers for Medicare and Medicaid Services (CMS) for the nation's nursing homes will be “effectively wiped out” by sequestration – now less than two months away.
 
Still another major development during the campaign was a new Journal of the American Medical Association (JAMA) article noting that knee replacements, and the extraordinary benefits they bring to patients, are up 161.5% among Medicare beneficiaries. However, the article reports, the $5 billion annual tab will continue to grow as America's 77 million Baby Boomers age.
 
Thus, we are hopeful that the significant campaign focus on Medicare cost control will also foster an environment whereby lawmakers, moving forward, can take better stock of individual providers' ability to offer the best value and quality for various procedures -- at the best price point for taxpayers.
 
While a variety of providers are capable of delivering high quality rehab care, the challenge – as well as the opportunity moving forward in terms of Medicare savings – is to help ensure the quality and cost advantages of the SNF rehab setting is more fully realized for procedures such as knee replacements, where this specific post acute care setting has inherent advantages.
 
We encourage the Obama Administration and Congress to examine more closely and objectively which providers can most optimally meet the growing demand for the critical rehabilitation care that sustains quality of life, independence, and, ultimately, lower costs to taxpayers. In the final analysis, the 2012 election has clearly been beneficial in helping the U.S. nursing home sector elevate our value proposition profile, and to set the stage for the critical budget and policy debate ahead.
 
Alan G. Rosenbloom is President of the Alliance for Quality Nursing Home Care, a coalition of 10 leading post-acute and long term care organizations providing Skilled Nursing Facility (SNF) care in approximately 1,400 facilities, in 44 states nationwide.
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