Provider advocates came out swinging Thursday over a McKnight’s story relaying a former government official’s claims that nursing homes share the blame in Medicare’s alleged “drifting toward disaster.”
Former Health and Human Services Secretary Mike Leavitt, now the owner of his own consultancy, released a white paper on Tuesday, arguing that immediate legislative action is needed to preserve the payment program. Formerly the nation’s top health official, he highlighted the specific problem of “quality indifference,” alleging that SNFs “that prevent unnecessary rehospitalizations are paid the same as those that don’t.”
The American Health Care Association bristled at that notion Thursday in a series of tweets, alongside several comments from readers on McKnight’s initial story.
“This report is completely inaccurate suggesting that nursing centers are paid the same regardless of rehospitalizations,” added Beth Martino, senior VP of public affairs for the nation’s largest eldercare association, in a statement to McKnight’s.
She pointed specifically to the SNF value-based purchasing and quality reporting programs that reward SNFs based on the quality of care they provide, and specifically reducing rehospitalizations. Providers are paid differently under those programs, ranging from a 2% cut to 1.65% increase under VBP, she said. And the Congressional Budget Office has found that those efforts have saved Medicare about $2 billion in spending, Martino said.
Asked to respond to concerns raised, Leavitt Partners said in a statement: “The point of the paper was not to blame any single sector of the healthcare system, but rather call attention to the need for all to move Medicare — and healthcare in general — away from the fee-for-service system and to a more sound payment and delivery system.”
Meanwhile, LeadingAge said in its own statement that it “strongly believes” that Medicare must be preserved as a safety net for adults. Ruth Katz, senior VP of public policy and advocacy, said the arrival of the new Patient-Driven Payment Model in October will base reimbursement on beneficiaries’ needs and alleviate some of Leavitt’s concerns.
“Gone will be the opportunity for nursing facilities to capitalize on providing a high volume of expensive services,” she told McKnight’s.
Katz also argued that Leavitt’s report overlooks the growth in popularity of Medicare Advantage, in which one-third of beneficiaries are now enrolled. Those plans include incentives to integrate services, provide them in more cost-effective settings and focus on patient outcomes.
“We disagree with him on the silos of services in long-term care,” Katz said. “Since he left HHS, trends in policy as well as consumer preferences have moved toward more integration of services. More and more of our nursing home members and retirement communities are diversifying their services into community settings.”
