2009 will be the year that we remember inaugurating an African American President who may lead the US into national health care reform (at this writing the nation is getting closer to some kind of health care reform).  It will also be remembered as the year with the worst recession since the Great Depression.  I've reported on comparative tax revenue collections in New York State throughout the year.  The 2009 versus 2008 comparisons by quarter have been dismal.  The first quarter shortfall was 18%, second quarter shortfall was 23% and the third quarter shortfall is 9% according to the Rockefeller Institute.  As the need for Medicaid and Healthy New York increase the revenue isn't there to support it.  Medicaid as always becomes a target for funding cuts and nursing homes will take its disproportionate share of the burden.  As we end the calendar year with anywhere from a $6.8 to 8.0 billion deficit in the next fiscal year we see cuts looming in an environment where Medicaid doesn't pay the bills.

The industry is also preparing for the impending change in both Medicare and Medicaid reimbursement methodology known as Value Based Reimbursement and the potential for bundled Medicare payments for acute/sub acute care.  This budget neutral methodology includes Regional Pricing and other tactics to shift funding to reward quality.  For Medicaid, this change is set to begin April 1 and significant work has been completed making implementation likely unless the Legislature takes steps to delay it.  If Medicaid Value Based Pricing is implemented in conjunction with recession related funding cuts, 2010 will certainly be memorable.

As you read this newsletter and the Caretech Budgetwire Blog, many of you may think that I am very pessimistic about the future of our industry.  In fact having been privileged to be associated with nursing homes for the last twenty-six (26) years I am cautiously optimistic.  To be a nursing home administrator is to be by definition both cautious and optimistic.  Whether it's the creation of community based programs, managed care for seniors or new program initiatives (i.e. sub acute care), nursing home administrators have a track record of prevailing and serving our older citizens along with the chronically ill.  2010 will require additional creativity of the proverbial out of the box thinking.  Caretech is one exceptionally important option that will help your facility withstand the challenges of 2010.

Caretech is more than a GPO; it is a strategic business partner helping you to better manage your supply expenses.  Caretech frees up management time necessary to focus on quality outcomes and positive consumer perceptions.  Caretech becomes your de facto Materials Management Department, providing Key Performance Indicators for both clinical and fiscal operations.  The information Caretech provides helps a facility keep expense under control and support positive clinical outcomes. The same innovative thinking that created community base programs can help organizations look to Caretech as a partner that will improve the efficiency and effectiveness on the facility.

I am passionate about Caretech.  As a corporate executive I had the opportunity to see how Caretech can improve an organization's fiscal and clinical performance.  Their willingness to develop new reporting systems (CareTrak, Spend down) was an eye opening experience.  My managers had timely information and they could address fiscal issues before they became fiscal problems.  Their ability to link fiscal spending to clinical trends in real time helped me to improve both areas of responsibility.  Their surveillance made me more effective.  So it' easy for me to be passionate about Caretech and I hope you will consider to potential benefit for your organization.

On behalf of all of us at Caretech - a happy and healthy new year!  We are there to assist you next year and look forward to helping your organization prosper in the difficult time ahead.