New provider payment system needed, nursing home alliance says

Dan Mendelson, CEO of Avalere Health

The Alliance for Quality Nursing Home Care said that 1) patient needs must drive payment system reforms, 2) payment systems must be more closely tied to comparative quality performance and 3) payment must be adequate to give providers the resources necessary “to meet growing patient needs and sustain the delivery of high quality care.”

“If we are really to rationally consider how to move forward and know that straight cuts simply don't work, how do we construct meaningful policies that benefit patients and rationally provide care and services across the spectrum?” posed Alan Rosenbloom, president of AQNHC. Dan Mendelson, president of Avalere Health, joined him in presenting the plan via a conference call Wednesday.

The billions of dollars of cuts have whacked the long-term care industry over a relatively short period of time, Mendelson said. The skilled nursing facility sector is facing $64 billion in funding reductions over the next decade, and both men said there needs to be a new direction forward.

“When you have this as context, it makes the point that it's getting increasingly difficult to find meaningful cost reductions,” Mendelson said.