Regulator insists brutal honesty from providers can turn the tide on Medicaid

Regulator insists brutal honesty from providers can turn the tide on Medicaid

DENVER — Despite perceptions of state officials being unapproachable or reluctant to help long-term care providers, the right provider stories can influence policies and help shift funding in the right direction.

That was the take Monday of two experts who’ve often been on opposite sides of state financing decisions but who have built a solid and open relationship. In doing so, they have fostered a higher level of staffing and funding support for nursing homes and other aging service providers.

Colin Laughlin, deputy office director at the Colorado Department of Health Care Policy & Financing, said working with and through regulatory officials can often be a more fruitful strategy than starting with lawmakers. Busy legislators may not have a broad understanding of existing healthcare policies or funding mechanisms. When providers do share their stories, whether with bureaucrats or lawmakers, he encouraged “brutal honesty.”

“Without providers in that space, sometimes, being very focused on what it’s like in that space, especially when it comes to the funding we have from Medicaid, it’s critical,” said Laughlin, a 10-year vet in the state’s LTC financing branch . “Without people educating and talking about what is ailing the industry, creating some administrative easements, if you will, trying to lessen the burden of the workers out there, knowing what they’ve experience during COVID, all of that, if it doesn’ t come from the provider, it doesn’t have the same impact.”

He was joined at a session at the 2022 LeadingAge Convention and Expo Monday by Deborah Lively, director of public policy and public affairs for LeadingAge Colorado.

“It’s really important for providers to advocate for Medicaid and for Medicaid changes because the state is always looking at broader policy implications, they’re looking at the budget overall, and I think that sometimes, the provider perspective can kind of get lost in that ,” Lively said. “Providers can talk to their Medicaid agencies and remind them what it’s like every day.”

Over the last several years, Colorado’s health department has advocated for and received a $225 million funding increase, a base wage hike for direct care workers across the continuum, and a 16-point plan to improve staffing. Much of that work has been informed by regular conversations between providers and the office that regulates them.

The state needs some 52,000 additional direct care workers over the next eight years, and the state health department is working closely with providers on how to find, fund and retain workers. Lively is chairing a state government committee exploring workforce solutions.

But attendees at the session from other states said they are often told they’re alone in voicing concerns. That’s a sure sign that individual providers need to play as big of a role as their local associations, said Joe Franco, grassroots policy director for LeadingAge.

Among the panel’s tips for building partnerships with state officials were:

• Demonstrating how things are working, or not, through real-life examples and data.

• Regular meetings or phone calls with state regulatory officials, as often as weekly.

• Refusing to leave the table when decisions go badly.

“Taking your ball and going home, that is a big missed opportunity,” said Laughlin. “Even if there’s disagreement, even if there’s different perspectives represented … I genuinely believe that almost everybody in this industry, independent of what position they’re in, is truly in it for the right reasons.”

Leave a Comment

Your email address will not be published. Required fields are marked *