Health Providers Must Emphasize Cost-Efficiency in FY 2012 Budget Debate

Capitol Hill lawmakers, regulators and the media have heard it all before at the onset of the annual budget dance: No cuts to Medicare — especially as state budgetary chaos has eroded Medicaid funding stability. With the 2012 budget debate about to get underway on Capitol Hill, the nature and composition of the new Congress — with an eye on spending cuts — will require health care providers of every stripe to emphasize how they’re part of the solution when it comes to saving tax dollars.

As Skilled Nursing Facilities (SNFs)  are the dominant provider of Medicare post-acute services, a recent Health Affairs article, “The Revolving Door of Rehospitalization From Skilled Nursing Facilities,” corroborates the general viewpoint that care quality and spending efficiency can be enhanced by policy reforms.

States the article, authored by Vincent Mor, Orna Intrator, Zhanlian Feng, and David C. Grabowski: “Payment incentives in Medicare do not encourage providers to coordinate beneficiaries’ care. Revising these incentives could achieve major savings for providers and improved quality of life for beneficiaries.”

An Avalere Health study conducted for one major provider group, the Alliance for Quality Nursing Home Care, echoes this sentiment in terms of possible savings: “Health policy experts view many of these [rehospitalization] incidents as preventable — to the tune of potentially $12 billion in annual savings, according to the Medicare Payment Advisory Commission (MedPAC).”

It further suggests “studying the sector can provide a unique window into addressing rehospitalizations, and that potential strategies to reduce this growing phenomenon can help sustain ongoing improvements in nursing home care, in addition to saving tax dollars.”

The first quarter 2011 health policy debate — with its inherent savings discussion — will be fertile ground upon which to advance SNFs’ and others’ public policy objectives in terms of making “savings” a central messaging thrust. Gordon Hensley

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