LeadingAge does not think the Biden Administration is putting its money where its mouth is when it comes to long-term care in this country.
In a letter sent to Department of Health and Human Services Secretary Xaiver Becerra, LeadingAge CEO and President Katie Smith Sloan expressed “deep concerns” about some of the actions the agency has taken, arguing that proposed payment cuts will reduce care access for older adults.
While the Biden Administration once laid out campaign promises to support older adults’ ability to access quality home health, the advocacy group raised concerns this week that is no longer the case.
Sloan worried the “fragile” long-term care ecosystem could “simply cease to exist,” especially for mission-driven, high-quality members, if some of the recent proposals laid out by the Centers for Medicare & Medicaid Services (CMS) and administration move forward.
With regard to proposed cuts to Medicare reimbursement for nursing homes, she questioned how the goals of the administration’s reform package could be achieved when the “financial equation simply does not add up.”
The release of last week’s home health prospective payment (PP) rule also riled LeadingAge, as the proposed payment reduction was counter to the letter and spirit of the Biden Administration’s “strong stand”on ensuring quality long-term care services and promoting services in home and community settings, Sloan said.
“Cutting Medicare home health payments by 4.2% including a 7.69% negative adjustment to the base payment coupled with an effort to cut an additional $2 billion from home health services, will have a devastating effect on older adults who rely on these services,” she wrote in the letter sent on Tuesday.
On the heels of CMS’s proposed Medicare funding cut for SNFs, Sloan felt it sent a “chilling message” to providers, especially those in the nonprofit space.
“If finalized, these cuts will significantly worsen the staffing crisis in these service lines and limit access to care for older individuals who need it,” she added.
She wants to see the administration take a more “holistic view” on the proposed rules before finalizing the “drastic cuts” that she feared have the potential for devastation across the care continuum.
“From our vantage point, the combined impact of the proposed payment cuts and current workforce and inflationary pressures would lead to waves of closures and the inability of providers that remain to take on new patients and residents,” she wrote.
Sloan also questioned how the administration will be able to achieve some of the lofty goals laid out in its recent nursing home reform package, as the workforce crisis remains critical for operators. Some providers reported that they hadn’t gotten an application for an open position for six months, the LeadingAge letter stated.
Gas prices and other commodity price hikes due to rising inflation and supply chain challenges further illustrate for Sloan the need to infuse more funding into the sector, not less.
“LeadingAge has integrated a renewed focus on diversity, equity, and inclusion [but] this pursuit is undercut when home health aides and certified nursing assistants, many of whom are immigrants or people of color, are likely losing money simply driving from home to home,” Sloan said.
Burnt out employees who have stayed in their jobs during one off the most difficult time periods for the sector should not be rewarded with fewer resources, she added.
“We should take what we have learned from these past two and a half years and put more money into the system so that our members can modify, adapt, and grow in response to the pandemic rather than continue to figure out where they can cut costs and ultimately, cut services,” Sloan wrote.
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