Lawmakers praise long-term care 'credibility,' Paul Ryan says consumers and providers both struggle

Long-term care providers earned exceptional credibility in the halls of Congress and now have a golden opportunity to push for more favorable policies, high-profile lawmakers and leaders of the nation’s largest provider association told an audience in Washington yesterday. Rep. Paul Ryan (R-WI) and Sen. Debbie Stabenow (D-MI) were among the speakers at the briefing for American Health Care Association/National Center for Assisted Living members, who are in the nation’s capital for two days of meetings with legislators.

Arguably the highest-profile speaker was Ryan, the Republicans’ 2012 candidate for vice president. He stumped for the type of “premium support” Medicare reforms that perennially are in the House budgets he puts forward. But he also offered a more personal take on what he called the “overregulation” of long-term care.

“I was in a nursing home this weekend with my aunt,” he said, which confirmed for him that people who haven’t interacted with the long-term care system “can’t understand” how complex it is. He said that three members of his family are helping his aunt, because “the system is needlessly complicated.”

His revamped version of Medicare would ease regulations by focusing more strictly on outcomes and giving providers more say in how quality should be measured, he said.

Stabenow cited long-term care providers’ willingness to work constructively with legislators as one reason they are being taken very seriously on Capitol Hill. For example, a plan tying skilled nursing facility reimbursements to hospital readmission rates — largely designed by AHCA/NCAL — was part of a Medicare reform bill passed earlier this year.

“We don’t see that from all providers,” Stabenow noted, praising the sector for putting Medicare dollars on the line.

Improved quality also has increased the stature of long-term care in the eyes of D.C. policymakers, said former Mississippi Gov. Haley Barbour (R). “There’s a huge difference in the way this industry is perceived on Capitol Hill and the way it was back in the mid-90s,” said Barbour, a founding member of lobbying firm BGR Group, which has long worked to advance the interests of long-term care providers.

AHCA Chairman Leonard Russ also emphasized that long-term care has built “an incredible … degree of credibility” both on the Hill and in federal healthcare agencies, which now are soliciting input from the provider community more than ever before.

Russ also said that “politically speaking, we don’t have any immediate, immediate asks,” because it will be another year until budget battles are renewed, and threats such as Medicare cuts to offset doctor payment reform now are on the backburner. Other speakers, including Barbour, Stabenow and Rep. Shelley Moore Capito (R-WV), also said that Congress likely will be moving slowly for the next several months, due to ongoing gridlock and upcoming elections.

This current atmosphere gives providers a chance to be more proactive, formulating and presenting big-picture reforms rather than simply reacting to stave off unfriendly policies, said Russ. To this end, he has convened a reimbursement cabinet at AHCA, and the association is developing a “payment blueprint.” Repeal of Medicare Part B therapy caps and addressing the observation stay problem are among other legislative priorities.

Pulitzer Prize-winning Washington Post columnist Charles Krauthammer, M.D., was the keynote speaker. He analyzed the electoral landscape, which he believes favors Republicans, and called Ryan the “brightest bulb” in the party.

The annual AHCA/NCAL Congressional Briefing is scheduled to conclude today.