Hike funding

How Pennsylvania’s Historic Medicaid Funding Success Can Be Replicated

Victory Towers are hard to come by when you’re an LTC. That is why, upon arrival, it is worth making at least two trips around the track.

Welcome to the current and dizzying position in which Pennsylvania long-term care providers, their advocates, and their lobbyists find themselves. In short, they won the state-funded figurative lottery and now everyone wants to know how they can too.

Pennsylvania Democratic Gov. Tom Wolf signed into law the life-saving legislation that the Republican-led Legislature formally approved. As we’ve reported, the windfall is jaw-dropping: a 17.5% hike in Medicaid pay rates, or about $35 per patient day.

Can this happen elsewhere? Absolutely, says Zach Shamberg, president and CEO of the Pennsylvania Health Care Association. There are two major keys, he believes.

First, the setting up of unorthodox partnerships. Second, an aggressive involvement of the providers themselves.

Being “vocal, visible and valuable” to the outside world turns heads and changes minds, ultimately.

“The lawmakers we brought to the table have become our greatest advocates. It was pretty amazing to see it grow,” Shamberg told me Thursday from a well-deserved vacation spot on the East Coast, where he was recharging batteries over a long weekend.

One provider strategy was to talk openly about finances and give anxious details whenever an operator closed or had to cut services. Doing it with a unified voice multiplied the effect. The basic message: We all lose if the state goes a 10th straight year without a Medicaid increase.

For envious peers across the country, many of whom have been ringing his phone over the past week, Shamberg suggests sticking devoutly to the theme of “unity.”

“PHCA, LeadingAge, unions, AHCA…they don’t need to be separated. We need to become one as an industry and share a unified message,” he stressed.

Indeed, LeadingAge Pennsylvania and others have also been a driving force in this historic victory.

In the end, all long-term care providers and patients won.

Advocates in other states would be wise to emulate the Pennsylvania stakeholder strategy. As would federal lawmakers, many of whom seemed to have lost their compass, no matter which side of the aisle they sat on.

“United we stand, divided we fall” has never rang truer. Long-term care workers need to keep this in mind.

In Pennsylvania, the grateful suppliers are still hoping to extend their winning streak. They won what they call lifeline funding through the Cares Act in 2020 and the US bailout in 2021. This year’s Legislature win (which technically starts January 1, 2023) is considered lifeline funding. “sustainability” – and hopefully sets the table for more success in the future.

Now that the Pennsylvania vendors have earned a seat at the table, they intend to move things forward. Surrounding states, after all, still have higher Medicaid payments and there are still providers cutting services and closing buildings due to staffing and admissions issues.

To the rest of the envious country, they also want to remind: once you have a megaphone, you better use it. Opportunity chains, while richly deserved, won’t last forever.

James M. Berklan is the editor of McKnight.

The opinions expressed in McKnight Long Term Care News the columns are not necessarily those of At McKnight.