Skilled nursing providers should be prepared for managed care to drill down on Medicare Part A residents, creating the potential for major financial problems, a long-term care expert warned on Tuesday.

Managed care experts “don’t see what value we add to the equation — you need to prove it,” said Jill M. Krueger, the president and CEO of Symbria in Warrenville, IL, during a session at the LeadingAge Illinois annual meeting. “The pendulum is going to swing and they’ll drill down on Medicare rates. Then you’ll show the data and it will swing back, but there will be a 3-year period where you need money in your piggy banks as money from Part A moves to managed care.”

In states where there is more managed care, the length of stay is as low as 14 days, said Krueger, speaking at a session titled “Contracting with ACOs and Other Multi-Provider Arrangements” with attorney and McKnight’s Ask the Legal Expert columnist John Durso,  In addition to a loss of census around a short length of stay, more patients are bypassing skilled nursing for home health, and SNFs can be excluded from narrow networks in ACOs.

Blogger comment:

Skilled nursing providers should be prepared for managed care … Wrong … long term care providers better be prepared for managed cost not managed care.  All of this, including Obama Care, is about spending not results.  Providers don’t have to produce results so how are we going to manage the care or measure quality … there is no accountability or episodic payment for restoring patients back to the community or preventing chronic illnesses so they don’t need hospitalization and/or ER.  CMS is using enforcement to penalize providers if their length of stay exceeds 14 days when the patients are all post hospitalization and need varying degrees of time to be restored.  It is a bogus system if it hinges on some rule of thumb or improvement criteria that have been ruled illegal (Fox v Bowe and Jimmo v Sibelius).

We, the taxpayer, are spending $2.6 trillion per year on input data not output results.  While the ACA Obama Care has reserved $1 trillion for enforcement and $1 trillion for demonstration academic projects to prove over the next ten years on what CMS has already decided … plus $1.2 trillion in additional patient linked taxes payable hospitals and physicians to bribe them to not fight the system.   How can this be affordable when the deductibles exceed the beneficiaries ability to pay.  I rest my case … this so called managed care system already failed in the 1980’s under the Hillary approach so why are we repeating a failed approach?