Washington, DC – In expressing its strong opposition to the Medicare Payment Advisory Commission’s (MedPAC) recommendation to the House Ways and Means Health Subcommittee today that skilled nursing facilities (SNFs) should receive no inflationary market basket update for FY 2009, the American Health Care Association (AHCA) said it is highly significant that members of the U.S. Senate and House are increasingly focusing on how the annual Medicaid under funding crisis negatively impacts the overall stability of the long term care sector.
“We are very pleased that nearly one hundred members of Congress, on a bipartisan basis, have specifically singled-out Medicaid under funding as a growing menace to the stability of the long term care sector, and patients’ ongoing ability to access quality long term care,” stated Bruce Yarwood, President and CEO of AHCA. “We applaud the growing number of lawmakers on both sides of the aisle who are increasingly vocal in their opinion that MedPAC’s views and Medicare policy prescriptions that are hurtful to their most vulnerable constituents.”
Letters championed by Senators Tim Johnson (D-SD) and Susan Collins (R-ME), and Representatives Shelley Berkley (D-NV) and Shelley Moore Capito (R-WV), signed by nearly one hundred members in their effort to oppose Medicare cuts in the Administration’s FY 2009 budget, states in part:
“Despite the growing demand for long term care, the existing financing mechanisms for Medicare and Medicaid are intertwined and increasingly dysfunctional. Medicare and Medicaid funding comprise the vast majority of all skilled nursing facility (SNF) payments. The Administration’s cuts are especially egregious when the drastic underfunding of Medicaid-financed SNF care is considered. For 2007, SNFs received $4.4 billion less than needed to cover the costs of providing care to Medicaid patients according to BDO Seidman. However, the Administration’s FY 09 budget fails to account for this perilous situation, which will only worsen as state economies continue to decline, since it calls for nearly $24 billion in cuts to Medicare SNF funding over five years.”
According to Yarwood, “It is a public policy error for MedPAC to dismiss the Medicare-Medicaid “cross subsidization” issue as irrelevant to the debate at hand – and based strictly upon the facts, market trends, and reality, MedPAC’s recommendations should be rejected.”
Yarwood said that given the dramatic cost increases facilities face in key areas including labor, energy, and health information technology, MedPAC’s failure to recommend an inflationary market basket update defies common sense, and is “wholly inadequate to maintaining our gains in care quality – especially as it limits our ability to recruit and retain qualified care givers, modernize aging facilities and equipment, acquire and implement new medical technologies, and meet the increasingly complex care needs of an aging population.”
Yarwood also pointed to a new analysis of New York State nursing home care that, he said, “is more illustrative of the marketplace realities MedPAC routinely ignores.” The report from the United Hospital Fund documents the growing role that skilled nursing facilities play as providers of short-term post acute care. The report also finds that the “number of patients staying in a nursing home for less than two months more than tripled,” from 1996 to 2005.
In addition to this rise in short-stay patients, the study further concludes that, “between 1996 and 2005, both long-term residents and short-term patients have become more disabled, and more of them are cognitively impaired.” The authors indicate that the findings of this study are representative of national trends. These facts further demonstrate why MedPAC’s recommendations are out of touch with skilled nursing facility patient needs and desires. “It is important to recognize the nursing home of the 21st century is far different from its predecessors, and while it’s excellent news that patients are returning home more quickly, the nature of treating older, sicker patients is increasingly problematic in the face of drastic Medicare cuts,” stated the AHCA President and CEO.
Yarwood concluded, “Consumers deserve the highest quality care and services across the spectrum of health care settings, and employees deserve well-paid, positive work environments. As the profession responsible for the care of our nation’s most vulnerable citizens, we are proud of the advances we have made in delivering high quality long term care services and we remain committed to sustaining these gains in the years and decades ahead – when, as we all know, demand for long term care will skyrocket.”
As the nation’s largest association of long term and post-acute care providers, the American Health Care Association (AHCA) advocates for quality care and services for frail, elderly and disabled Americans. Compassionate and caring employees provide essential care to one million individuals in our 11,000 not-for-profit and proprietary member facilities.