Poorly designed quality measurement, data collection and data sharing rules could cause big problems for care providers.
Gayle Kvenvold, president of Aging Services of Minnesota, and Patti Cullen, president of Care Providers of Minnesota, have made that argument in a comment letter sent to their state's Care Integration and Payment Reform workgroup.
Aging Services, a group of groups with an interest in aging, and Care Providers, a trade group for long-term care (LTC) providers, have teamed up to form a Long-Term Care Imperative coalition.
PPACA drafters were hoping the provisions would get Medicare and other insurers to change the way they pay doctors, hospitals and other care providers.
The idea is that new payment programs can get providers to think in terms of maximizing health and minimizing care costs for a whole patient, rather than charging as much for services as possible and providing as many services as possible.
Kvenvold and Cullen said the care integration workgroup should talk more about the importance of coordinating long-term care (LTC) along with acute health care.
The workgroup itself already has suggested that rural health care providers and providers that serve niche populations will need extra technical help.
The workgroup should talk more about the kind of help that rural LTC providers will need with sharing data with other types of providers, such as hospitals, Kvenvold and Cullen said.
To participate in the new care coordination programs, rural LTC providers will definitely need help with data sharing, Kvenvold and Cullen said.
LTC providers also need protection from new quality measurement programs that drown the providers in new, redundant paperwork, Kvenvold and Cullen said.
Anyone who's developing quality measures should try to base the measures on the huge amounts of quality data that the providers already report, Kvenvold and Cullen said.
"Cost is an especially important concern in long-term care, where medical assistance (and, for nursing facilities, private pay) rates have been frozen for the past four years," Kvenvold and Cullen said.
Any new quality measurement programs also should be flexible enough to allow for innovation, Kvenvold and Cullen said.
"We do not want to experience an unintended consequence of discouraging unique programs and services because the measurements won’t 'fit' their program," the coalition leaders said.
- PPACA: Risk corridors vs. rebates
- Minnesota: Feds should handle health risk adjustment
- Minn. governor removes exchange creation from state insurance regulator