3 bold predictions for the coming year in long-term care

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John O'Connor
John O'Connor

Anyone attempting to predict the road ahead should consider a statement recently served up by House Speaker Paul Ryan.

When the Wisconsin Republican was asked whether revenue growth from the government's new tax plan would offset the deficit it's likely to rack up, he delivered up one of the more metaphysical statements you're likely to hear.

“Nobody knows the answer to that question because that's in the future.”

Can't argue with that logic. In fact, nobody knows the answer to any question that remains in doubt. The best we can do is make educated guesses. Just ask any meteorologist.

Still, there's nothing like a budding new year to awaken that urge in scribes to warn better-informed readers what to expect. It must be some kind of occupational hazard.  So in the spirit of not always being right but never being in doubt, here are three predictions you can take to the bank.

1.    The powerful will try to get even more powerful

Thanks to a roaring economy and new tax breaks, corporate America is more flush with cash than usual. And what's the point of having money if you can't use it to make more money, right? Look for the big skilled care chains and real estate investment trusts to gobble up smaller fish, and perhaps absorb ancillary businesses that seem to make sense. Will these moves turn out to be inspired, or will they be viewed more like bender-inspired tattoo choices? Hey, this column is about the future. For a better answer to the expansion question, you'll probably need to attend the 2020 NIC conference.

By the way, look for even bigger fish such as insurers, drug companies and health networks to tap into this market with similar intent. A lot of the big boys are going to look very different by this time next year. As for some of the small boys? Well, they just might not be around. Or if they are, you might not be able to recognize them.

2.    Medicare and Medicaid will be targets

Speaking of Mr. Speaker, Ryan all but guaranteed the GOP will be sizing up Medicare and Medicaid for funding cuts in 2018. Look, somebody has to pay for that $1.5 trillion or so funding gap in our shiny new tax bill. While he has since walked back his comments a bit, he has intimated that some providers are compensated too much by Medicare and it's still pretty clear that the so-called deficit hawks will be more than happy to break out the carving knives.

For long-term care operators who get most of their funds from these two programs — which is to say virtually all of them — such ominous intentions amount to fighting words. Let's just say our friends at the American Health Care Association and LeadingAge are in for a rough ride. If operators thought they were defending their lives on Capitol Hill before, just wait.

3.    Tech tools, tech tools, tech tools

We've been writing for some time about the growth of technology in this sector. Believe me, that was mere prologue. This is looking to be the year when tech tools literally become a make-or-break proposition for many post-acute players.

Let's start with analytics. If you don't know how to get the information you need that proves your worth in the brave new world of uncertain hospital transfers, you'd better do so, pronto burger. Then again, maybe it's already too late. You'd better have a compelling story to tell in which you are the hero, and be able to back it up. That starts with serious data collection and analysis capabilities.

Then there are the, ahem, ancillary technology tools. The tech for billings, electronic health records, patient monitoring and so forth. Yeah, you'd better have that stuff too. Or start talking buyout terms with any bigger fish who'll take your call. That is, if they are not already sniffing around.

So there you have it. Three ironclad, all-but guaranteed predictions to watch and manage in 2018. Will other things, possibly more notable developments, also occur? Yeah, probably.

Will my three predictions pan out? Let's just say I'm at least as confident as our House Speaker.

John O'Connor is McKnight's Editorial Director.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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