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AHCA/NCAL First Quarter Advocacy Blueprint. 2014 . Objectives. To ensure that SNF providers do not receive an additional rate cut or reduction in the Market Basket increase.

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Ahca ncal first quarter advocacy blueprint

AHCA/NCALFirst Quarter Advocacy Blueprint



  • To ensure that SNF providers do not receive an additional rate cut or reduction in the Market Basket increase.

  • To advance a solutions driven agenda that is beneficial to our members and incorporates volume shifting policies to the SNF sector.

  • To achieve an earlier implementation date of MMR reforms consistent with the Senate version released in December 2013.

  • To ensure passage of Part B extenders in 2014.


  • Strengths

    • Strong relationships with growing reputation as a constructive advocacy group.

    • Commitment from House Leadership to avoid provider cuts.

    • Key staff support of volume shifting savings concepts.

    • Solutions fully developed that score savings.

    • Chairman and staff changes on Senate Finance Committee.

    • Unified sector with strong political presence.

    • Quality indicators are improving.

  • Weaknesses

    • Not cut in last two SGR patches. (Making us a target)

    • Timing of SGR expiration is concurrent with other important deadlines.

    • Patch or permanent fix will require offsets.

    • Truncated congressional work calendar. (9 weeks)

    • Perception of high Medicare margins.


  • Opportunities

    • Advance alternative savings solutions that mitigate risks for cuts both legislatively and in the press.

    • Advocate for non-healthcare pay-for’s.

    • Advance legislation that resolves the observation stay problem.

    • Amplification of progress on quality

  • Threats

    • Congressional propensity to make provider cuts in lieu of thoughtful reform.

    • Other provider groups advocating cuts to SNF’s.

    • MedPac recommendations being used as justification to cut rates.

    • Provider cuts outside of market basket resurfacing (Provider tax, bad debt)


  • Nine month SGR fix most likely outcome at a cost of approximately $12B.

  • Continuing to prepare for the possibility of a permanent SGR fix is prudent in light of low price tag.

  • Environment remains extremely volatile with a multitude of possible scenarios.


  • Continuing our messaging strategy focused on key members and leadership.

  • Focus message on quality progress and low margins as reason for no additional cuts.

  • Aggressively develop/finalize pay-for policies (bundling, re-hospitalization) to propose as an alternative to traditional cuts. Simultaneously advocate for alternative pay-for alternatives.(hips/knees)

  • Continue to intensify political engagement and fundraising strategy in Q 1 of 2014 towards key members. (Front loading events in light of timeline)

  • Explore collaborative opportunities with others in post acute space.