Seeing optimism where others only have doubt

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James M. Berklan, McKnight's Editor
James M. Berklan, McKnight's Editor
Mark Parkinson makes a lot of sense when he talks about the future of long-term care.

One of his key points is that providers must be the cost and quality solution. The president and CEO of the American Health Care Association's hypothesis is that government programs are not going to have enough money to pay all the different types of providers out there, so the government will become more “rational” with its payouts.

Providers who put up good numbers and outcomes will get paid well; those that don't are liable to be left out altogether.

It's similar to a theme Larry Minnix, his counterpart over at LeadingAge, has been singing for years: In the future, there will be two kinds of LTC operators — the excellent and the nonexistent.

Parkinson's advice to providers is threefold. First, learn everything you can about new payment models. The way you will be reimbursed by the government is going to change.

Second, quality will become a reimbursement issue. Noble caregivers will still be valued, but successful outcomes will be rewarded the most.

Third, as a provider, you must adapt and diversify. The rise of post-acute rehab and assisted living since 1980 illustrate providers can do this. This means home health, hospice, pharmacy services and more might become a greater part of your operations.

Where Parkinson makes even more sense is when he gazes into his crystal ball on the topic of hospital readmissions. Right now, one nursing home might receive 40% of a hospital's discharges, he notes. Four other long-term care operators might each get 15%.

Parkinson believes that soon, just one or two providers might get all of a hospital's discharged patients. The other three or four in the scenario above would get nothing.

Meanwhile, smart LTC providers will use the Hospital Compare website to find how a local hospital scores. Then the provider will create a care program that will improve conditions. Grateful hospitals will then create a clear, profitable pipeline to and from LTC facilities, and base it on measurable data.

Parkinson doesn't just throw an armful of papers in the air and exit the room. He also brings optimism, and he's correct in thinking high-quality operators can corner more market share and profit.

The key word there, of course, is profit: because in addition to good sense, it's also about “good cents” for healthcare organizations.

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