Donald Trump’s victory in the presidential election may have taken many by surprise. Corporations and individuals alike are still wondering how the incoming administration will impact their livelihoods. For the healthcare industry, and long-term post-acute care (LTPAC) providers, big questions remain unanswered:
What will happen if the Affordable Care Act (ACA) is repealed?
What’s in store for Medicaid?
Will value-based reimbursement continue?
Are block grants a real possibility?
Answers to these questions impact both the way consumers pay for healthcare and the way LTPAC providers bill for it. In this post, we’ll share several possibilities for how the Trump administration could affect the LTPAC industry.
Repealing the ACA
Let’s pretend for a moment that the ACA goes away in year one of Trump’s presidency. The obvious outcome from such a turn of events would be a loss of insurance for 20+ million people. But, repealing the ACA could also impact funding for the Medicare program – specifically, Part A hospital and nursing home expenses. The 2016 Medicare trustees’ report projects that, under intermediate assumptions, the Hospital Insurance Trust Fund will become insolvent in 2028, two years earlier than estimated in the prior year’s report.
In with the Old, out with the New?
If the ACA is repealed, something else could disappear along with it – the Center for Medicare & Medicaid Innovation (CMMI). And, if the CMMI goes away, so will the governance and financing of Alternative Payment Models (APM). Without APMs like mandatory bundled payments, patient-centered medical homes and accountable care organizations, the old Fee for Service (FFS) reimbursement model could be poised for a comeback.
Block Grants for Medicaid Funding
Block grants, a lump sum of federal money paid to each state for Medicaid expenses, are one funding possibility favored by the Trump administration. While President Trump hasn’t always seen eye-to-eye with House Speaker Paul Ryan, the two do seem to be on the same page here, making block grants an increasingly likely possibility. How exactly this money would be distributed throughout the states is uncertain. However, it is clear that states would expect to see less federal money than they do under current law.
Fewer Government-Mandated Regulatory Requirements
Health and Human Services Secretary, Tom Price, is a staunch opponent of the ACA, mandatory bundled payments and regulations in general. So, it’s reasonable to anticipate fewer government regulations for healthcare under the new administration. One possibility is that government-mandated health IT initiatives, such as Meaningful Use, could be pared back or effectively eliminated. Skilled nursing facilities may also benefit from the “less regulation” philosophy of the Trump administration, especially as it relates to the newly released Requirements of Participation.
Actions Speak Louder than Words
Of course, none of these potential outcomes should be taken as a given. Candidates have a history of saying one thing on the campaign trail and doing another once in office. According to McKnight’s Long-Term Care News, industry experts do not expect a full repeal of the ACA or a return to the FFS model.
So, what’s really going to happen?
We know that change is definitely coming. The uncertainty is what it will look like and how it will affect our industry. This is why MatrixCare will continue to monitor the legislative and regulatory environment and offer solutions as changes impact LTPAC.
Want to learn more about how MatrixCare technology can help you stay in front of regulatory changes? Contact us today.