Cutting Medicare to nursing homes is poor healthcare policy

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Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care
Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care

As Capitol Hill redoubles its efforts to come to consensus on a healthcare reform bill, the long-term care community feels it is important to make one point clear: We support the need for healthcare reform. We believe in the goal of expanding access to quality, affordable health care to as many Americans as possible. As is always the case, however, it is the details and how we achieve that goal that has our community concerned.

The Alliance for Quality Nursing Home Care has long made quality improvement the centerpiece of our agenda.  We are committed to providing quality care to the vulnerable seniors entrusted in our care. We also support transparency in the management of our facilities. These are points we can agree on with our leaders in government. Where we differ with those writing the health care reform legislation is on how it is funded.

In the legislation proposed by Congress, deep cuts to Medicare funding for nursing home care are included. While we understand that need for shared sacrifice, it is vital we take current economic reality into consideration. 

The Alliance will soon release a new quarterly publication, produced by the independent analysis group, Avalere Health, called Care Context, examining both the types of nursing home residents and the funding streams which our facilities rely on. The report shows that skilled nursing facilities rely heavily on both Medicaid and Medicare funding.

"In FY 2007, Medicaid was the primary payer for about 56.4 percent of nursing facility patient days and Medicare was primary for approximately 13.1 percent of patient days," the report states.

Unfortunately, with the economic condition our governors are grappling with in the states, Medicaid payments to nursing homes are eroding significantly. This is coupled with the fact that in July, the Centers for Medicare and Medicaid Services cut Medicare funding for nursing home care by $12 billion [over 10 years]. This combined one-two punch means there is little more the long-term care community can give without threatening thousands of jobs and the quality of care we can provide to our residents. 

The skilled nursing facility community believes additional support is possible in order to help the country achieve badly needed reform to our healthcare system.  However, any further changes to nursing home care need to be driven by sound policy and not merely by a need to make the numbers add. 

There are numerous policy initiatives we support that would mean true savings to the Medicare system. For example, avoiding unnecessary re-hospitalizations, providing better care coordination and extending policy initiatives to place Medicare patients in the lowest cost setting appropriate to their needs would help to reform the system and would be wins for patients, their families, workers and providers. 

Again, while we understand that congressional leaders must seek savings to help finance Americans' expanded access to health care, additional cuts to Medicare funding for nursing home care along the lines being proposed today just isn't sound policy and doesn't make sense for our seniors.

Alan Rosenbloom is president of the Alliance for Quality Nursing Home Care.

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