Washington, D.C.—Good morning, ProviderNation. Well, that escalated quickly: In a frenetic few weeks, regulators have posted rulemaking notices on bundled payments for joint replacement surgeries, antibiotic stewardship, and a megaton draft that focuses on “competence-based” performance measurements for the nation’s long term and post-acute care centers.
That last item is taking up most providers’ bandwidth, coming as it did on the morning that the fifth White House Conference on Aging got underway. (It’s worth noting, almost pathetically, that as world-shaking as the 400-plus page rulemaking notice might be, it was worth all of 22 words in President Obama’s speech to the Conference on Aging: Small wonder that many providers feel that they’re the Rodney Dangerfields of American health care.)
Among the sections in the competence-based rulemaking notice—which the Obama administration itself advertises as the most “sweeping” changes to care center regulations in 25 years—are a series of questions about whether to band mandatory arbitration agreements. The fine folks at the American Health Care Association/National Center for Assisted Living have long opposed mandatory agreements, but some provider advocates are worried that the language of the rulemaking notice is too vague. And, for a lot of advocates, vagaries are like chum on the water for the trial bar.
In any case, if you’ve got thoughts on the proposed rules, AHCA’s indomitable Lyn Bently would love to hear from you by Aug. 6.
For now, though, the big takeaway from last week’s White House conference is that nothing is written, says Oklahoma’s own Tom Coble, who attended the festivities last week. “There’s just a lot of work that needs to be done,” he says.
Coble says he was impressed by how committed the attendees were to genuine elder care, and he was encouraged at the seemingly universal agreement that Americans have to rethink their prejudices about getting old. But, watching the panels and the discussions, Coble says he’s still struck by the enormity of the problem. “I think the aging of America is something that everyone acknowledges, but until we experience it, personally, it’s just out of sight, out of mind,” he says.
Part of the problem is that too many Americans seems to view elder care the same way they view plumbing. “We all meet the senior care industry when our mothers and fathers enter it,” he says. “Once they’re out of system because they no longer need it or they’ve passed on, then there’s no further interaction with the system. It’s important when you need it, but once you’ve used it, you’re not going to interact with that system for a long time.”
That’s discouraging in one way, Coble says, because it means that it’s difficult to sustain any kind of Big Public momentum for change. On the other hand, it’s a real opportunity for providers to hone their craft so that, when the day comes, they’ll be ready.
“Hopefully, we’re in the right place at the right time as we develop these relationships and have new ideas and new solutions to the problems that will allow us to have an impact on what’s going to happen in the future,” he says. “We have to continue to deliver quality in our centers at home, where our elected officials will encounter our industry and what we do to care for their loved ones.”
Finally, in other news, Pluto.