Skilled nursing operators—and those who invest in the sector—are no strangers to challenges. Over the past few years, government, payor, and operator initiatives across the country have been working to create a new health care delivery and payment system, and these initiatives are expected to continue for the foreseeable future. In fact, some industry leaders suggest that it could be two years until we see a narrowing of networks and partner alignment that will expose the winners and potential losers of the emerging system.
David Gruber, MD, MBA, Director of Research and a Managing Director with Alvarez & Marsal Healthcare Industry Group, recently authored a timely, interesting, and provocative report entitled, “Post-acute Care: Disruptions (and Opportunities) Lurking Beneath the Surface.” The report provides a perspective on the rapidly aging U.S. population, the evolution of payment reform, and the implications of these changes on the post-acute care sector. Increasingly, payors, providers, and investors are being affected by the ongoing consolidation of hospitals, health systems, and physician practices, as well as the emergence of advanced payment models that are changing the competitive landscape among all post-acute care providers. The author writes: “With healthcare moving away from facility-centric reimbursement, the post-acute care sector is facing an inflection point that will produce clear ‘winners’ and ‘losers’. Our analysis is intended to help operators take the steps they need to stay competitive and continue serving patients, a necessity as the U.S. population ages and requires healthcare institutions that can meet a complex array of medical, behavioral, functional and social needs.”
In the last major release of economic conditions prior to the presidential election on November 8, the Labor Department reported on Friday that nonfarm payrolls increased by 161,000 positions in October. Hiring has now averaged 181,000 new positions per month over the past 10 months and 176,000 per month over the past 3 months. The year-to-date average was down from average monthly gains of 229,000 in 2015. Nevertheless, since 2010, nearly 15 million jobs have been created. The October gain was less than the consensus projection of 175,000 positions.
The U.S. Government Accountability Office (GAO) concluded an investigation into data from the Centers for Medicare & Medicaid Services (CMS) on nursing homes, staffing practices, and financial performance by recommending that CMS make such data more easily accessible by the public and ensure the data’s validity. In the course of the investigation, the GAO revealed insights about margins and operations relative to the skilled nursing properties’ organization types. The agency’s report underscores the need for more and better financial skilled nursing data in the industry.