Providers rewarded for sticking with it
James M. Berklan
One could excuse long-term care providers if they're walking around looking over their shoulders right now. I can personally identify with that.
That's because hard-working reporters and editors throughout the years have come to suspect that if things are going too well … well, something bad must be about to happen.
And make no mistake: There has been some very good going on for providers lately.
I put Friday's unveiling of a new resident classification system and a 2.4% Medicare pay hike at the top of the list. Surely, the intense analyses being conducted by the association pros in Washington are going to dredge up less-than-ideal provisions. You're bound to get that somewhere in the new classification system and a 266-page proposed payment rule.
But can I reiterate that a 2.4% raise is coming? Nobody gets all of the $850 million that this increase represents all by themselves, but compared to recent years, this is nothing to sneeze at.
Then, there's the new resident classification system, the Patient-Driven Payment Model (PDPM). True to its mantra, this administration has once again eliminated layers of regulatory complication. At least that's the favorable story about PDPM that we've been hearing since Friday.
In brief, Centers for Medicare & Medicaid Services Administrator Seema Verma figuratively told providers, “You spoke and we heard you.” The new PDPM system has 80% fewer possible classification groupings than last year's tentative RCS-1 plan. This might wind up leaving too few groupings to give enough precision (so let's circle back in a year or two on that) but some glaring omissions from RCS-1 were remedied, and other paperwork and regulatory burdens also were stripped out of the process.
Clearly not the typical day at the gym for providers used to getting their noses bloodied.
The administration, in fact, says its new proposal will bring providers $2 billion in savings in soft costs over 10 years. It's always tough to put solid dollar figures on such theoretical projections, but, good grief, when was the last time the federal government gift-wrapped a regulatory package like this?
As I noted earlier, it's too early to go dancing in the streets. We're not sure yet how well the government will pay for the hard work ahead. And there is still that ever-present “other shoe must drop” angst.
But for now, providers should take pride in the fact that federal regulators seem to have listened (and, oh yes, given them a lot of what they wanted). That's a victory in anybody's book.
Follow Editor James M. Berklan @JimBerklan.