Nursing home industry wrong on managed care
Louisiana is missing a major opportunity to improve the quality of health care for seniors and save state dollars at the same time, writes Andrew Muhl with AARP of Louisiana in a letter to the Advocate. Muhl takes issue with arguments against moving to a managed care model raised in a letter last week by Alexandria nursing home owner Lawrence Kolb:
In the letter, Mr. Kolb discusses the new proposed health care delivery model for aging Louisianians, known as Bayou Choices. Bayou Choices is a managed long-term support and service program that uses a team approach to care, and replaces the current, antiquated, fee-for-service Medicaid system, which has drained our health care budget and forced many Louisianians into institutional care…
Mr. Kolb claims this new model will never produce any real savings to the state or provide quality care. Unfortunately, he has the facts completely backward. Analysis from the state’s health department reports that savings to the state could reach as much as $10 million in year one and more than $68 million by year three…Failure to move forward will mean that current waiting lists for people who want to receive the support services they need to live at home and be productive will continue to grow longer and services will become more threatened.
But the state’s powerful nursing home owners have been using more than words to oppose managed care–they’ve been using their checkbooks, as reported by the Huffington Post:
A total of 78 nursing and rehabilitation homes operating in Louisiana contributed a combined $357,879 to American Future Project or Believe Again. Nearly all of the nursing home contributions to both American Future Project and Believe Again were made on April 13, meaning they were collected at a fundraiser attended by Jindal…This year the industry lobbied against the Jindal administration’s push to privatize the management of long-term care services provided under Medicaid. Nursing homes fear that management companies will divert funds from them toward home and community services, including home health aides and other services that allow seniors to stay in their own homes. Jindal’s administration punted on the privatization of elder care, stating that the next governor, elected in 2015, will have to deal with the decision.
Hospital deal falling apart
The charity hospital privatization deal in north Louisiana between LSU and the Biomedical Research Foundation (BRF) seems to be set for a shake-up. Greg Hilburn with the Shreveport Times has details on the fight over the hospitals in Monroe and Shreveport:
The university served formal notice to Biomedical Research Foundation claiming the foundation breached its operating agreement and “must withdraw as the parent company of the University Health System.” But BRF Chairman Steve Skrivanos called the notice “a sham”…Thursday’s action is the latest volley in a feud that simmered all summer. In a press release, [LSU President] Alexander said, “We have exhausted all avenues to resolve our differences amicably and now must take action that we hoped would not be necessary…” Alexander said a new group of civic leaders has stepped forward to bridge the transition to a new operating partner. He said Academic Health of North Louisiana Hospital Management Co. Inc. plans to announce its board members soon…Skrivanos said the dispute with LSU will also likely be resolved in court.
As Marsha Shuler with the Advocate writes, the deal has long been plagued by problems:
The deal has been fraught with controversy from the beginning because it involved a private foundation with no experience running a hospital taking over. In addition, Foundation executive John George of Shreveport — served on the LSU Board of Supervisors as the agreement was being struck. More recently, the Foundation sued a hospital competitor accusing it of violating federal antitrust laws and trying to take away LSU-affiliated doctors and paying patients.
By Gov. Jindal’s admission, the charity hospital privatization is an alternative to expanding health coverage to the uninsured. Unfortunately, it has proved more expensive for state taxpayers, even as the evidence shows that coverage would be more beneficial for patients and families–a clear lose-lose.
Federal aid to states on decline
Michael Leachman with the Center on Budget and Policy Priorities warns that federal support for state and local governments is set to fall to its lowest level in 50 years because of Congressional budget politics, putting even more pressure on state budgets:
The 2011 Budget Control Act (BCA) imposed annual caps on discretionary funding, which includes most of the programs that support state and local priorities outside of health care, including schools, fire departments, and water treatment plants. These caps have already cut federal support in many areas. For instance, Title I funding for high-poverty schools is 11 percent below the 2010 level, adjusted for inflation.
A Message from the Pope
Like many people–Catholics and non-Catholics alike–the Dime took time yesterday morning to watch Pope Francis address a joint session of Congress, making a powerful case for action to help the poor and needy and work to build a more equitable society that provides opportunity for all:
I would encourage you to keep in mind all those people around us who are trapped in a cycle of poverty. They too need to be given hope. The fight against poverty and hunger must be fought constantly and on many fronts, especially in its causes…In particular, I would like to call attention to those family members who are the most vulnerable, the young. For many of them, a future filled with countless possibilities beckons, yet so many others seem disoriented and aimless, trapped in a hopeless maze of violence, abuse and despair. Their problems are our problems. We cannot avoid them. We need to face them together, to talk about them and to seek effective solutions rather than getting bogged down in discussions.
You can read the entire speech here.
Number of the Day
$357,879 – Amount Louisiana nursing home owners donated to Gov. Jindal’s presidential PAC and a related election group in April, a week before it was publicly reported the governor was delaying managed care reforms opposed by the industry (Source: Huffington Post)