James M. Berklan, Editor

You might usually see them chatting up colleagues, either from a conference hall stage or amid cocktail hour. Or maybe your connection comes from messages popping up on your computer screen.

Whatever your experience with long-term care lobbyists, you better hope they’re good at their game now. 

After the bombshell announcement earlier this week that the Centers for Medicare & Medicaid Services is not going to take smaller steps to try to recoup overpayments generated by the “new” Patient Driven Payment Model, it is lobbyists’ goal to persuade them to do just that.

Almost immediately after PDPM rates went into effect in October 2019, provider leaders were aware that they were getting unexpected largesse from the new Medicare payment system. In fact, their resigned discussions quickly became wondering how, not if, CMS would start clawing back the “extra” money it was doling out.

Then the pandemic hit and all otherwise normal worries went out the window. CMS had its hands more than full and it sensibly didn’t try to rearrange the lawn furniture while the hurricane was still in the front yard.

While conditions are still pretty stormy for providers, however, the highest winds appear to have moved out to sea and regulators are more interested in remodeling again. And they want payment for the $1.7 billion job up front.

This is where it gets really dicey.

Last year the major provider associations — the American Health Care Association and LeadingAge, along with a host of compadres  — successfully rallied long-term care professionals to submit hundreds, perhaps thousands, of comments to federal regulators. Objections were delivered en masse and the powers that be temporarily backed off.

In a nutshell, that’s the game plan again. Long-term care leaders are not asking that the cuts be taken totally off the table but rather spread out over more than one fiscal year. Whether this strategy has any legs with the honchos in Washington or at CMS headquarters in Baltimore, no one knows.

Long-term care leaders will be recruiting

But it won’t even become an issue if officials don’t have enough objections to consider in the first place. In other words, if you haven’t already, you can probably count on your block captain to tap you on the shoulder soon to let CMS know by June 10 what you think of its proposed huge pay cut.

In the meantime, it will be up to some of the industry’s finest dressed members in the nation’s capital to exercise their persuasion skills. It won’t be easy. But at least in this round for the minds and hearts of policy makers, long-term care will not be directly up against the hospital or physician lobbies. That’s a funding and muscle mismatch that usually doesn’t end well for the non-acute caregivers.

That’s positive, but there are also still significant cons to this one scenario. For example, consumer advocacy groups who feel they have statistics and momentum to finally set things “right” about nursing home staffing and a variety of other irritating issues. And if they need a boost to make their point, they simply trot out pandemic casualty numbers like some game of pin the tail on the providers.

Some other numbers, however, also speak for themselves.

I’m talking about research that shows that while hospitals and other healthcare sectors have almost gained back their pandemic staffing loses, nursing homes are still far behind — by more than simple double-digit percentages. Long-term care is down in the work-preference category and until that turns around in the hearts and minds of potential job candidates, all the administering from on high isn’t going to make much of a difference.

There is one other consideration in this looming lobbying battle. This industry knows what it’s like to be almost perpetually in persuasion posture. Whether through good fortune or necessity, its influencers have shown they know how to fashion an appeal and successfully see it through.

Here’s to seeing what their “A” game looks like.

James M. Berklan is McKnight’s Long-Term Care News Executive Editor.

Opinions expressed in McKnight’s columns are not necessarily those of McKnight’s.