American Health Care Association

Issues

Medicaid is the primary payer for long-term care in the United States, with 64 percent of nursing home residents and 19 percent of assisted-living residents depending on it. Medicare Part A covers short-term skilled nursing care in Medicare-certified skilled nursing facilities (SNFs) under certain conditions, while Part B helps cover outpatient therapy services; Medicare does not cover custodial care. In July 2020, CMS issued a final rule establishing a 2.2 percent net increase in Medicare reimbursements for nursing homes for Fiscal Year 2021, effective October 1, 2020.

AHCA supports Medicaid reimbursement changes that link payments to quality or efficiency and believes reforms should account for different provider types and populations, emphasizing that funding should be used only for high-quality, medically necessary services. It advocates for gradual changes to allow iterative input. AHCA opposes any Medicaid reform that shifts funding burdens to state and local governments or providers. In January 2020, AHCA opposed the Medicaid Fiscal Accountability Regulation (MFAR), which would end long-standing exemptions and discounts for some facilities.

According to AHCA/NCAL, typical nursing homes operate on low or negative profit margins because Medicaid reimbursements cover only 70 to 80 percent of costs, often relying on Medicare post-acute care payments to subsidize Medicaid care—a model strained by the COVID-19 pandemic's reduction in surgical procedures.

Quality improvement

In February 2012, AHCA/NCAL introduced The Quality Initiative, setting specific, measurable targets to improve care in nursing and assisted living centers. AHCA/NCAL provides skilled nursing care centers with resources such as the Quality Award Program, LTC Trend Tracker, Gero Nurse Prep, and Nurse Assistant Training to support quality improvement.

Research and publications

AHCA develops and compiles research and data on the long-term and post-acute care industry from its own work and government agencies, aiming to inform the public and policymakers. It publishes a weekly email newsletter called Capitol Connection and a monthly magazine titled Provider, covering legislative, regulatory, and other issues. Members also have access to AHCA/NCAL Notes, NFP Newsletter, and DD Digest.

Events

The annual long-term care industry event includes speakers, education programs, and networking. Members convene annually in Washington, DC to raise awareness of issues and meet with congressional representatives.

The AHCA/NCAL Independent Owner Leadership Conference is for independent owners and not-for-profit operators of 10 or fewer facilities. Another annual conference focuses on quality improvement for long-term care professionals. AHCA established National Nursing Home Week in 1967, renamed National Skilled Nursing Care Week in 2018, held in May starting on Mother's Day. NCAL established National Assisted Living Week in 1995, held in September starting on Grandparents’ Day.

Did You Know?

• Mark Parkinson, a former governor of Kansas, succeeded Bruce Yarwood as CEO and president of AHCA in 2011.
• Clifton J. Porter, II is the first Black CEO of AHCA/NCAL.