Giving Trump a chance
There's a pretty good way to gauge the sector's anxiety level when something major occurs. Simply note the resulting outcry, or the lack of it.
Whenever MedPAC announces Medicare payments should be trimmed or left alone, you can bet industry leaders will deliver a swift and stern rebuttal. Should a new study reveal inadequate Medicaid payments? The industry will loudly and indignantly reply. Yet when something that will clearly benefit the field happens, you're not likely to hear much more than an obligatory response. If that.
That's why it's interesting to see how this sector has generally responded to Donald Trump's recent presidential victory. In other quarters, demonstrators have taken to the streets. Some observers are predicting Armageddon. As for the long-term care sector's reaction? You might say the silence has been just about deafening. So was the field pulling for Trump all along?
It's an interesting question. To be sure, many operators will quickly tell you they find the man morally reprehensible. Not to dredge up the many accusations against him, but it's unlikely he'll be nominated for the Humanitarian of the Year Award anytime soon.
Yet many in the senior living sector appear willing to overlook his flaws because of something more significant: the assurance of better days to come. And if you happen to be running a long-term care facility, that promise can look pretty enticing.
This is, after all, a man who said he would start dismantling the Affordable Care Act (better known as Obamacare) during his first day in office.
As operators know all too well, one of the law's goals is to make value-based payments the new reimbursement standard. So what happens if value-based payments are also a casualty? Do we revert to a fee-for-service system? That outcome is hardly out of play. And you don't need to call your accountant to realize how such a reversal could greatly improve your finances.
Trump also said he would take on regulators with ferocious vigor. For most operators, that's the kind of talk that could incite an involuntary happy dance. From new Federal Register rules that won't be posted to the possibility of a toned down survey and certification system, what's not to like?
To be sure, it won't all be crimson and clover. It never is. Especially if Medicaid block grants (which he supports) are put in place. This payment approach is built on the premise that specific budget allocations are all the government will pay. In other words, once the money is gone, it's gone. You didn't get your fair share? Better luck next time.
Still, it's a pretty rare operator who can make the argument that this business – and yes, long-term care is a business – would be better served by what the Democrats had to offer: more regulations and harder-to-justify Medicare payments.
Admittedly, this is all very preliminary speculation. And a lot can happen once the proverbial rubber starts hitting the road.
Here's the bottom line: Donald J. Trump is our president-elect. Regardless of our personal leanings, we would all do well to wish him well. He is, after all, soon to be the person in charge of our country. Besides, he just might turn out to be the sector's best friend in the White House since Ronald Reagan.