John O'Connor

For more than a decade, skilled operators have been telling lawmakers and regulators that they are the cheapest post-acute care option out there.

It appears the Medicare Payment Advisory Commission has not only heard the claim, but wants to take the industry up on it.

Last Thursday, the advisory panel recommended that the timeline for pending Medicare payment reforms be moved up three years. What this means is that a unified system encompassing all post-acute care providers may kick off even sooner than most expected.

On the face of it, this would appear to be great news for skilled care facilities. After all, if this happens operators would not have to jealously look on while rehab hospitals reap larger Medicare payments for delivering largely identical post-acute services.

The American Hospital Association certainly seems to feel that way. In a classic foot-dragging maneuver, they have called on the commission to compile more payment-related information before moving forward with such a plan. Uh-huh.

It would appear MedPAC is not buying it. Many commission members have had it up to here with slow-go recommendations that sound an awful lot like a push to keep the status quo in place for as long as humanly possible.

In fact, the commission’s chairman, Francis J. Crosson, had this to say at last week’s meeting:

 “This is a big deal for Medicare and beneficiaries, and should occur as quickly as possible.”

That’s not to suggest the commission wants to ride roughshod over patient protections. In fact, several members are recommending that pilot programs be put in place in order to keep unexpected hiccups to a minimum.

Even long-term care industry groups — which you would think can’t get the change soon enough — are being somewhat cautious. They are publicly stating that vulnerable Americans need to be protected. And who can argue with that? But they probably wouldn’t be too upset if their members don’t get fiscally shafted by the unified payment system to come, either.

What can be said with full certainty is that the next decade should be an interesting one for post-acute care as it affects the elderly. Skilled care operators appear more than ready to compete against rehab hospitals. But what about assisted living and home care players who want a piece of that action?

Guess we’ll find out.