LeadingAge New York Adviser Winter Vol. 1 | Page 29

(continued from page 27) care organizations about the needs of this populations and what needs to be covered for payment (Such as Home Health Aide services). Poor Medicaid reimbursement for Private Duty Nursing is a particular issue that limits our ability to discharge patients as well. We spend a lot of effort, both for in-patient and at-home pediatric patients, to provide education to others about the unique needs this population requires. So, in light of those challenges what keeps you up at night? Like most providers, we live on a reimbursement roller coaster and the uncertainty of future dollars is really troublesome. I cannot predict exactly how we’re going to get paid, or estimate what we’re going to get paid, three to five years from now. I worry that the contracts that the managed Medicaid plans are going to have with the State won’t be adequate to cover the costs of services that we provide and therefore the plans are going to try and cut back on services. Right now we have a mortgage that we have to pay which is covered, by regulation, by Medicaid. If that capital cost gets passed over to plans it becomes a factor of negotiating with each plan. It will be difficult to ensure that I’ll be able to pay our mortgage much less our operating costs. Also, we are a very tiny, downstream provider and within many different Performing Provider Systems (PPSs) through Delivery System Reform Payment Incentive Payment (DSRIP). Right now, I have no idea how and if, money is going to trickle down to us from the PPSs. We’re putting an enormous amount of time and energy into being good partners and bringing creative ideas but I have no idea what it’s going to mean for us. So it is really the uncertainty of the dollars in the future that most often keeps us up at night. I think that when they wake up to the true needs of moving medically complex kids to the community, ultimately, we’re going to be a very important player within these PPSs because of our continuum of care, our in-patient and community-based programs and case management capabilities. But ultimately we have no control. It’s just a matter of “how well (continued on page 29) leadingageny.org 28