Thursday January 11, 2001
Seattle—
The Center for Long-Term Care Financing's most recent report, "The LTC
Triathlon: Long-Term Care's Race for Survival" (published on 12/7/00 in
.pdf format at www.centerltc.com/pubs/recent.htm) is now available in
hardcopy from the Center. The report is
free to media and lawmakers. The cost is $49.95 for others and bulk discounts
are available. Contact the Center at info@centerltc.org with your order or for more information.
Based
on interviews with 119 of the leading private financiers, providers and
insurers of long-term care, The LTC Triathlon study is a penetrating analysis
and critique of long-term care public policy.
(See the full press release announcing publication of the report at www.centerltc.org/triathlon_release.htm.) Don't assume, however, the opinions and insights of the largest
LTC players covered in the report are necessarily related to the scale of their
organizations. Smaller players are
facing some of the very same challenges!
In the Winter 2001 issue of Meadowbrook Ripplings, the newsletter of the
Meadowbrook Extended Care Center in Seattle, WA, administrator and editor
Virginia Sternberg identifies (in her column reprinted below) one of the most
important and repeated themes of the Triathlon report findings. Namely, insufficient government
reimbursement (via Medicare and Medicaid) threatens providers' ability to offer
quality care and, in some cases, even their existence. Sternberg points out, as
well, the benefit of having more private pay residents (who pay the full market
rate for their care) to counteract the negative impact of below market
government
reimbursements.
As to Sternberg's point that state and federal governments must do more for
Medicaid recipients, we agree. But improving the program for the benefit of the
truly needy won't happen (especially as Medicaid budgets around the country are
now being squeezed by higher costs and growing enrollment) unless and until the
vast majority of Americans plan ahead with insurance or otherwise and avoid
Medicaid. This is the only way the Medicaid
programs can survive and even flourish to provide high quality care to those
most in need.
Absent public policy reform that motivates people to plan ahead, however, Ms.
Sternberg and her fellow providers will continue on a perilous course—for them
and for us. The Center offers it's LTC
Triathlon report in an effort to foster progress in the right direction.
Here's Ms. Sternberg in her own words:
"An Important Message to Our New President Elect George W. Bush:
"Our Federal and State Leaders Must Learn More About the Economics of
Caregiving
"Everyone's attention has been focused on nursing homes and their
inability to meet the quality of care needs of the elderly who require their
services. Instead we need to focus on
our state and federal governments and their responsibilities to meet the needs
of the elderly--namely, the Medicare and Medicaid recipients who depend on the
federal and state governments for funding.
"Show me the skilled nursing facilities (SNFs) that are having a crisis
with quality of care issues, and I will show you that these facilities are the
very same facilities that have a high population of Medicaid (welfare)
recipients. Moreover, these are the
same facilities that bought into upgrading their rehabilitation services by going
into debt to better serve the Medicare population. The government then pulled the rug out from under them and
reduced the reimbursements—the Prospective Payment System (PPS), even though
the Medicare recipients were going to receive better trained, better equipped
facilities. These kinds of economics do
not work. When a business upgrades,
they do so with the expectation of receiving either the same revenue and
perhaps, hopefully, even more. What
business would ever go into debt to upgrade with the expectation of receiving
less?
"The federal and state governments blame the SNF operators, but those of
us close to this industry know where the problem is. You will not find a SNF with a higher percentage of private pay
customers doing very little Medicare business going bankrupt, like many have
these past two years. Now what does
this tell you? The government can spend
all the money they want on determining staffing ratios, they can have all the
committee meeting they want, but the buck stops there. The bottom line is: the governments
(federal/state) do not pay their fair share.
"What's more, and what is even more unfair, the private pay are actually
subsidizing the Medicaid (welfare) and more recently some of the Medicare
recipients. Some smart consumers go so
far as to call around to find out what a facility's private pay/Medicaid ratio
is because they know the higher the Medicaid ratio, the poorer the care.
"If we are going to continue to mix the private pay with the Medicaid
(welfare) and the Medicare recipients, then efforts should be in the direction
of making it equitable for all. Our federal and state leaders need to learn
more about the costs of caregiving."
_____________
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