Parkinson: Medicare Fix: Let’s Get It Done

This year is a good time for change. With the Congressional Session underway and new faces on Capitol Hill, Congress is uniquely positioned to fulfill some of their new year resolutions early. And there’s no better opportunity than permanently fixing Medicare’s flawed physician payment formula, the Sustainable Growth Rate (SGR).

No other new year resolution has been put off as much as the permanent SGR fix. In fact, Congress has “patched over” this issue 16 times in the past 11 years. If you’ve seen our ads around town, you know that we are ready for that to change.

We’ve dubbed this effort Positively Skilled because we want lawmakers and their staffs to better appreciate how we are improving patient outcomes, while finding real savings in Medicare.  You’ll see this reflected in every ad, along with the data to prove it.

Today, a deadline is looming. Unless the system is patched, physicians will face a reimbursement cut of 20 percent by March 31st.  Another short-term patch shouldn’t cut skilled nursing care and potentially harm the over 3.9 million residents and patients we serve every year.

So how will our ads be received on Capitol Hill? We think very favorably. Here’s why:

We continue to have a strong track record on quality. Those aren’t empty words, they’re fact. Skilled nursing centers have reduced their use of antipsychotics by 17.1 percent since 2013. In 2015, we are working to reduce it even more, to 25 percent. With each decrease, thousands of lives are being improved.

We’re dedicated to stopping the revolving door of rehopitalizations. Since 2012, we’ve decreased hospital readmissions 14.2 percent nationwide. In 2013, 63 percent of hospital admissions were successfully sent home to their families. In this area alone, skilled nursing care has saved the Medicare program $360 million. It doesn’t make sense to cut an industry that has already saved so much.

We collaborate to create sound policy solutions. In legislation passed last March, we worked with Congress to link payments to quality provided in our centers. That value-based model is the kind of hands-on approach that we bring to everything we do.

And we’ll continue to improve. With a multi-year approach, we’ll offer viable policy alternatives while enhancing care delivery back at home.

With estimates projecting 27 million Americans needing long term care by 2050, cutting programs such as Medicare and enacting temporary patches is not sustainable. Skilled nursing care has been cut repeatedly and significantly over the last several years.  If cuts are needed to pass a permanent fix, value-based cuts to low-performing providers would be preferable to across-the-board cuts, as long as high-performers are rewarded.

No matter the process or the time length, however, we will be engaged and eager to continue offering constructive solutions.

With broad support from both sides of the aisle, the timing is right for a permanent SGR fix.   Congress, let’s tap into that synergy and get Medicare SGR reform done this year, You’ll be carrying out a new year resolution that will improve the lives of so many Americans that you represent. We, America’s skilled nursing care providers, stand ready to help create a policy with the dual role of achieving Medicare savings and improving care delivery.


Mark Parkinson is the President and CEO of the American Health Care Association/National Center of Assisted Living in Washington, DC

Morning Consult