Some feathers may have been ruffled in Wednesday’s Senate Appropriations Subcommittee on Health and Human Services, as the committee discussed, and later adopted, budget recommendations that will almost surely be included in the Senate’s budget.
One big ticket item up for discussion was whether a plan, known as the prospective payment plan, that would fundamentally change how nursing homes are paid is a good idea or not.
While the chair, Sen. Anitere Flores, noted that the scheme is being included to put it in a posture for budget negotiations between the House and Senate, she also recognized that it may not end up being ready for “prime time” if it doesn’t gain widespread support.
That broad support didn’t seem likely though as committee testimony pitted the industry against one another. With some nursing homes speaking (or waiving) in favor and some speaking out (or waiving) against. One clear voice in opposition to the plan was LeadingAge Florida and its members, including Martin Goetz from River Garden Senior Services in Jacksonville and Kip Corriveau of Bon Secours St. Petersburg Health System.
Steve Bahmer of LeadingAge Florida after committee said: “We appreciate Senator Flores recognizing that the prospective payment plan included in the Senate HHS budget does not yet have universal support, as LeadingAge Florida is deeply concerned about many aspects of the plan.
We believe it hurts our state’s good providers, shifts dollars to poorer performing providers, and, ultimately, puts the state’s Medicaid beneficiaries at risk.”
Bahmer continued to say that he looks forward to working with Flores and her fellow legislators, but, at this juncture, would “urge lawmakers to carefully evaluate the very serious impacts this plan could have on the state’s frailest seniors residing in nursing homes.”
Adding to the cacophony on the nursing home payment plan was Sen. Kevin Rader, who questioned why four and five-star facilities seem to lose money, while one and two-star facilities would gain money under the plan.
Rader also asked why this was the first time the committee members had a chance to hear and discuss the plan, as updated documents were not available on the date of the committee meeting. And, the Senate’s nursing home payment plan, while based on a plan produced by Navigant — shelved earlier this year in by Rep. Jason Brodeur’s committee — varies in some key ways that some in the industry say makes the plan even worse.
According to Emmett Reed, executive director of the Florida Health Care Association: “FHCA and our more than 550 members have championed the cause to improve quality for more than 60 years. We strongly support the Senate PPS plan because it changes reimbursement in a way that incentivizes high-quality outcomes for long-term care residents.”
Reed noted that the vast majority of nursing homes support the reimbursement reforms, as FHCA represents 82 percent of all nursing homes in Florida.
The Senate PPS plan will invest an additional $26 million in four- and five-star nursing homes and drive improvements in lower-performing facilities. The plan will increase accountability and enhance return on the state’s investment in nursing home care by ensuring that money is spent on direct care and quality improvements.
We’ll be watching this unfold at FloridaPolitics.com, as this could be the start of a budgetary food fight, especially considering that this plan seems to have been produced far from the sunshine and without a clear consensus from the industry.