After the decision: Get your house in order

In the wake of last week’s 5-4 ruling by the U.S. Supreme Court to uphold the Affordable Care Act (ACA), long-term care providers are taking stock of the far-reaching ramifications for an industry in transition.

And while the decision to uphold the major components of the law came as a surprise to many, it only confirms the direction savvy providers have been heading in reaction to a rapidly evolving healthcare system. As former Centers for Medicare & Medicaid Services Administrator Donald Berwick, M.D. noted recently, reforms were underway, regardless of how the Supreme Court ruled. The “reform train has already left the station,” he said in a speech at the American Health Lawyers Association annual meeting in Chicago.

The message from LTC experts and analysts was familiar and one that we’ve presented repeatedly in news, articles and blogs over the past two years since the act was signed into law: Get your house in order. It’s time to work smarter and harder in partnering with hospitals and referring agencies. It looks like accountable care organizations are here to stay and data and metrics are critical to demonstrating your facility’s ability to avoid hospital readmissions.

Kathleen Griffin, PhD, national director of post-acute and senior services at consulting firm Health Dimensions Group, and an expert on integrated health systems, echoed Berwick’s remarks in a conversation I shared with her immediately after the ruling was announced.

“Post-acute providers have a great opportunity to take the initiative with hospitals to identify the data that they will be providing and [demonstrating] how it will help the hospitals,” Griffith says. “Then [they can use] the data to target areas where the hospitals and post-acute provider can overcome operational issues and process issues, or develop protocols and care pathways that standardize care—to realize a reduction in readmissions.”

Speaking to the ruling’s limitation on Medicaid expansion, LeadingAge President and CEO Larry Minnix says Medicaid programs are moving toward managed care programs with more flexibility for states and now’s the time to “get in there and help design those plans.”

To support LeadingAge’s members in their efforts to grab a seat at the policy table, the association has created a leadership development agenda focused on six leadership imperatives: fulfilling the not-for-profit responsibility; engaging consumers more effectively; cultivating talented people; leading innovation; creating a new financing paradigm; and pioneering technology.

Today, indeed every day, thousands of aging services providers are back at work caring for our most frail and vulnerable population. And as Minnix noted, “Government policies come and go; we still have to care for older adults.” 

Patricia Sheehan

Patricia Sheehan was Editor in Chief of I Advance Senior Care / Long Term Living from 2010-2013. She is now manager, communications at Nestlé USA.