Prospective Payment System Serves Greater Good, Adds Value to Nursing Center Care

By Cliff Bauer
Miami Jewish Health Systems

I recently traveled to Tallahassee for discussions with my local legislators about the benefits of a prospective payment system, which is a method of nursing home reimbursement.  With over 30 years of senior management experience in health care management, I fully endorse this proposed change just as I had embraced the PPS change in Medicare hospital reimbursement earlier in my career.  

Miami Jewish is a not-for-profit organization that been providing long term care in South Florida for 77 years. With more than 420 beds, we are the largest nursing home on a single campus in Florida, and the largest single Medicaid provider in our field – almost 300 of our residents rely on Medicaid to cover their long-term health care needs.  

This new model will, for the first time ever, link the amount nursing homes are reimbursed to health quality outcomes. Our current system is arcane.

There is a larger moral imperative at play here. Government and nursing homes must embrace a system that focuses on patient quality and overall costs. We must drive VALUE in all health care. The PPS model   goes deeper than picking “winners” and “losers,” far more important than any individual home’s “bottom line.”

Current legislation serves the greater good by allowing more nursing homes to offer state-of-the-art facilities where families can comfortably visit, and where residents can benefit from technology upgrades and other improved services that greatly enrich their lives. The PPS proposal passed by the Florida Senate offers VALUE, so I hope legislators will see that value and include a PPS when they pass the final budget.

Like many other businesses, we exist in a competitive marketplace. In my experience, though, when the needs of our greatest generation are placed squarely in the forefront, we all benefit.