PPS: How bad is it?

PPS: How Bad Is It?

Is the Medicare Prospective Payment System (PPS) in need of a major congressional overhaul? Long-term care providers, at least as represented by the American Health Care Association (AHCA), are resoundingly in favor of this. Besides pushing Congress to back the Hatch bill (see October News Notes), which at press time had yet to begin its journey through Congress, AHCA was shouting from the highest public relations rooftops that "bankruptcies underscore the severe impact of Medicare cuts." Using the example of the Vencor bankruptcy, AHCA said this "is not an isolated incident" caused bythe 1997 Balanced Budget Act (BBA) and its financial noose tightening. "Skilled nursing facilities, from nonprofit and faith-based centers to state and national chains, are being affected by these Medicare cuts," said AHCA, and "in the end, it's people who are being hurt."

The goal of any public relations, of course, is to get press coverage so that an aroused public will contact Congress and the White House. The Clinton administration, however, might prove to be a tough sell. President Clinton's Medicare reform proposal to Congress is quite modest on BBA changes, dedicating $ 7.5 billion over 10 years to correct access problems created by the BBA, an amount that must be shared by all Medicare providers, including home health agencies and "disproportionate share" hospitals. And, to make nursing- home -oriented PPS fixes a tougher sell, the Department of Health...