I recently participated in a roundtable discussion that addressed the field’s challenges and opportunities. (Note: Full coverage will appear in the November issue of McKnight’s Long-Term Care News.)

  Several remedies for improving care and payments surfaced during the conversation. But one unique suggestion really stood out: Perhaps long-term care should become a public utility.

Yes, this does sound like a bit of a stretch. But then again, let’s consider what public utilities do. They provide the public with something that is essential, whether it’s electricity, gas, water or telephone services. Is there any doubt that we need an adequate supply of eldercare services?

Clearly, there would be pros and cons to any such move. Here’s the best reason (at least from a provider’s perspective) why this option might make sense: Public utilities can charge reasonable rates for the products and services they provide.

Imagine a world where states and CMS don’t dictate what you’ll be reimbursed.

Or where auditors aren’t rechecking every dotted “i” and crossed “t.” And where you could help control your fiscal destiny.

You have to admit, that sounds a lot better than spending a small fortune trying to convince state and federal overseers to quit turning the fiscal screws. Small wonder that one of the industry’s most powerful executives joked that he’d kill for the payment assurances that would accompany being a public utility. (Sorry, but you’ll have to read the November issue to find out who that person is).

It’s tough to dismiss an option that could make the biggest hurdle facing your business disappear. But it’s not likely that long-term care as a public utility will become reality. There are numerous reasons, but perhaps the most powerful is this: There are simply too many independent-minded owners and operators in the field. The odds of them rolling over and collectively agreeing to be part of a utility? Pretty low, to say the least.

So barring some incredible pot sweeting, or an existential threat, I don’t think we’ll be seeing long-term care operators dealing with state commissioners any time soon.

Of course, this prediction is based on the assumption that the choice will be the industry’s to make.

John O’Connor is Editorial Director at McKnight’s. Follow him on Twitter @ltcritr.