Alliance for Quality Nursing Home Care acknowledges importance of fine-tuning Medicare payment system

But Key SNF Provider Group Acknowledges "Absolute Need to Get it Right" in Fine Tuning Medicare Payment System to Protect Seniors' Care, Preserve Workers' Jobs, Ensure Accountability to Taxpayers

Expressing alarm about a proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) that could result in funding reductions as high as $4 billion to seniors' Medicare-funded skilled nursing care, the Alliance for Quality Nursing Home Care today acknowledged the importance of fine-tuning the complex and evolving Medicare payment system in a manner that "gets it right" while also protecting seniors' care quality, preserving caregivers' jobs, and ensuring accountability to U.S. taxpayers.

In issuing the proposed rule yesterday, CMS officials outlined two approaches to correcting the Medicare payment system for skilled nursing care: one that would impose immediate and deep funding reductions of more than 11 percent on skilled nursing facilities (SNFs) and the patients they serve; the other, a more measured approach that would ensure any system-wide correction is based on meaningful data, analysis and thoughtful, collaborative review. The Alliance comments are directed at the former approach.

"We are deeply concerned about a proposal that would impose immediate and deep payment reductions of more than 11 percent based on limited data from the new Medicare SNF payment system," said Alan Rosenbloom, President of the Alliance.  "However, we agree that it is critical to achieve an appropriate level of Medicare funding for SNF care, and we believe that can and should be done while also maintaining quality and stability within the SNF care system.  Our goal is to work with government officials to 'get it right' by fine tuning our Medicare payment system in a way that assures seniors are protected, SNF economics are sustainable, jobs are secured and accountability to taxpayers is assured. Our mutual objective is an accurately calibrated payment system under Medicare."

Rosenbloom also stressed the need to "address this issue in the context of other issues affecting SNF care- giving before taking precipitous action." The Alliance leader pointed to key factors, such as rising patient acuity, shrinking length of stay, escalating costs, and plummeting state Medicaid funding as an important context for decision-making on Medicare funding issues. "These are vital variables meriting consideration as the process towards a final rule ensues," he said.

Besides noting that the SNF sector is America's second largest health facility employer after only hospitals – accounting for 1.7 million jobs with a total impact of over $201 billion annually on U.S. economic activity – Rosenbloom underscored the immense value of SNF care to growing numbers of Americans. "In addition to being a vital pillar of the U.S. economy and pivotal to badly-needed economic expansion, SNFs have invested heavily in recent years to increase capabilities to admit, treat and return to home a rapidly increasing number of patients requiring intensive post-acute rehabilitation and care for multiple chronic illnesses," the Alliance leader said. "By treating these high-acuity beneficiaries in low-cost SNFs, Medicare ultimately saves funds. This is a baseline fact that cannot be ignored."

Rosenbloom added, "We intend to work with government officials to create a sustainable approach to fine tuning Medicare's SNF payment system – one that is in the best interest of seniors, caregivers and taxpayers, and which contributes to the ongoing strength of our Medicare system."