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Current State of the Sector
Mark Parkinson, AHCA President and CEO
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Sector Background
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The Numbers Supply of Investment-Grade* Seniors Housing and Care Properties in the U.S. (as of Q4 2013**) ***One nursing bed is equivalent to one unit. Source: NIC Research
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How We’re Doing
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Short-Stay vs. Long-Stay
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Key Factors: How People are Doing
State in which they operate Payor mix Debt structure
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Opportunities
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Aging Population
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Challenges
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Federal Government is Broke
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Risks That We Face Have Changed
2010 The Hill CMS Changing Payment Models 2016
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Changing Payment Models
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Population Growth – 80-84 Years
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More People Will Need Our Post-Acute Services
Source: SNF Volume from Avalere projection model; Medicare enrollment from 2015 Trustees’ Report
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Some Providers Will Win
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What CMS Wants
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CMS Support of Health Care Delivery System Reform will Result in Better Care, Smarter Spending, and Healthier People Key characteristics Producer-centered Incentives for volume Unsustainable Fragmented Care Systems and Policies Fee-For-Service Payment Systems Key characteristics Patient-centered Incentives for outcomes Sustainable Coordinated care Systems and Policies Value-based purchasing Accountable Care Organizations Episode-based payments Medical Homes Quality/cost transparency
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During January 2015, HHS Announced Goals for Value-Based Payments Within the Medicare FFS System
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Implications of Changing Payment Models to Law
Incentive for therapy is eradicated Pressure on length of stay New theories of liability
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2016 Election
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2016 Election House – Unlikely to change Senate – In Play
246 Republicans 188 Democrats Senate – In Play Republicans defending 24 seats Democrats defending 10 seats Presidency – In Play
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Likely Result Senate will go to whoever wins the presidency
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All Republican Line-Up
Medicaid at risk Reduction of provider tax Block grant proposal Per capita cap Other supplemental payments
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All Democrat Line-Up Congressional gridlock continues
CMS still very active
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Tort Liability
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2015 Aon Report: Key Findings
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2015 Aon Report: State by State
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