A recent article in Newsweek entitled “You Don’t Want to Be Old in These States” amplifies a longstanding dilemma confronting long-term care providers in rural settings across America. The Medicaid program is broken – where inadequate funding is a breeding ground for unfortunate incidents like this. The negativity fueled by such circumstances should be a call to action rather than a blemish on the industry and its majority of compassionate providers of care to our Medicaid dependent elderly.
The emerging landscape of the collective Senior Living Industry is leaving the chronic care resident behind – particularly the resident dependent upon Medicaid funding. The industry remains highly fragmented where providers remain payer driven – more focused on payer sources to subsidize if not abandon the losing proposition of Medicaid funding. It’s time for the industry to come together to leverage the proven “low-cost” alternative of the nursing home setting – and drive legislative change rather than being policed in a reactive fashion by escalating regulations.
All constituents to the industry have ownership in the circumstances we confront. As we migrate away from fee for service to more outcomes oriented payment systems, antiquated government payer programs focused on cost reductions require reengineering to foster more integration and alignment of all providers.
It is essential that payment reform reaches across the “continuum of care” – providing reasonable incentive for all providers in the most cost effective and efficient care setting. Perhaps a solution could stem from thoughtful integration and redistribution of public funding – aligning interests rather than fueling a divide. It is no surprise that the aging inventory of nursing homes in rural America where there is inadequate public funding to support reasonable costs of care or for reinvestment in property interests is breeding “horror stories” like this. They will remain unavoidable until we catch up with the times.