Behind the Scenes in Washington: Advocating for Iowa's Nursing Homes

In early June, I traveled to Washington, D.C. with the Iowa Health Care Association (IHCA) and several skilled nursing facility (SNF) leaders to advocate for the long-term sustainability of nursing home care. Over the course of three days, we met with key members of Iowa’s Congressional delegation to discuss the challenges providers face and the policies that can either strengthen or weaken their ability to deliver care.

The Mission: Protect Vital Funding for Care

Our primary focus was protecting the Medicaid Provider Tax, a funding mechanism that allows states to draw down federal matching dollars. These funds are critical for many SNFs, helping them recruit and retain the registered nurses needed to care for increasingly complex patients. While effective and widely used, the Provider Tax has recently come under scrutiny and could face future cuts without strong advocacy.

We also raised awareness of two related issues:

• The widening gap in Medicaid reimbursement, which often fails to reflect the real cost of care delivery.
• We were opposed to the mandatory staffing level regs. But we were grateful for the newly proposed 10-year delay, giving providers time to build a sustainable workforce before regulations are enforced.

Healthcare Economics That Work

During our meetings, we emphasized a key reality: hospital recovery costs Medicare on average $2,500 per day, while skilled nursing facility beds average around $500–$600 per day. Redirecting appropriate patients to SNFs for skilled care is a proven strategy to reduce system-wide healthcare costs and improve patient outcomes, resulting in higher patient satisfaction scores.

But that strategy only works if nursing homes are properly staffed, and in many cases, Provider Tax funds are what enable facilities to schedule RN coverage for these higher-acuity patients. Without it, cost-saving transfers from hospital to SNF may stall, and the care-delivery-system as a whole suffers.

Connecting Policy to Practice

I’ve learned that when you speak from experience and can connect-the-dots, policymakers listen differently. My advantage stems from experience at multiple levels of care delivery. During the Affordable Care Act, I represented Iowa as a CMS committee member tasked with designing the new delivery of care models being used today. At the health system, clinic and home health levels, I’ve been involved in Board governance for over eight years. However, my true passion remains senior living and how this industry survives in the ACO delivery of care model long into the future.

We didn’t travel to Washington D.C. just to recite statistics. We were there to provide real life examples of how funding shortfalls negatively impact patients, local providers at multiple levels, and create headwinds for favorable outcomes.

Why Relationships Matter

Advocacy is about more than attending meetings or reciting generic talking points. It’s about building a relationship based on trust, developing a passion for facing industry challenges together, and being part of the solution.

That’s something I’ve always believed in. And it’s something we practice at AssuredPartners every day.

We understand that reimbursement structures, regulatory pressures, and workforce issues are interwoven. That’s why we’re proud to partner with associations like IHCA and lend our voice where it counts.

If your organization is navigating similar funding or compliance challenges, we’re here to help.