By Stephen Tweed  

What does the election of Donald Trump to be President of the United States mean for home health care, hospice, and private duty home care?

I’ve been listening and reading a lot about what others are saying.  The coastal elites, the talking heads, and the editorial writers are all expressing their opinions about what this means.  These are the same people who were all wrong in projecting the outcome of the election, so how can we trust what they say now?

I don’t know what will happen in the near term future, but I do know the position staked out by Donald Trump and other conservative leaders before the election.

Donald Trump on Health Care

Here’s what he said:

• Repeal and replace Obamacare with HSA’s (Health Savings Accounts)
• Work with Congress to create a patient-centered health care system that promotes choice, quality, and affordability
• Work with States to create high-risk pools
• Allow people to purchase insurance across state lines
• Maximize flexibility for States with Block Grants so local leaders can design innovative Medicaid programs

Paul Ryan on Health Care

We also looked at the work done by Paul Ryan, Speaker of the House of Representatives.  Mr. Trump stated he wants to work with Congress to create a patient-centered system. What might that look like:

• Make health insurance portable
• Expand patient-centered health care
• Preserve employer-based insurance
• Allow sales across state lines
• Allow small businesses and individuals to ban together
• Back wellness programs
• Enact real medical liability reform
• Protect patients with pre-existing conditions
• Protect coverage for young people
• Prohibit sudden cancellations
• Bring younger and healthier people into the system
• Bring Medicaid into the 21st century
• Provide relief from Obamacare’s raid in Medicare

Mike Pence Introduces Obamacare Replacement Plan

At an event just before the election, Vice President-elect Mike Pence outlined his approach to replacing Obamacare.

• Get rid of the individual mandate
• Allow people to purchase insurance across state lines
• Create a transition period for those receiving subsidies
• Make it easier for Americans to open Health Savings Accounts
• Instead of giving subsidies to big insurance companies, provide assistance directly to the people through HSAs
• Free the states from top-down approach to Medicaid
• Create greater transparency in health care costs, and quality of care
• Protect Americans with pre-existing conditions

Are You Seeing the Patterns?

As you look at these three lists of principles to replace the Affordable Care Act, what do you think?  Will these ideas work to make our health care system better?  How will these changes affect health care at home?

I don’t know about you, but my crystal ball is broken.  I stopped trying to predict the future many years ago, but I’m getting much better at watching the trends and the patterns.  As I listen to our newly elected leaders, and read what they have written, I begin to get a glimpse of what might happen. There are some things I like, and some things I question.  The key will be execution.  Can these new leaders put the right people in the right places to execute with excellence to reform our health care system in a way that works for all Americans?

As leaders in home care and hospice. we need to be paying attention to these trends or patterns of change.  Then we need to prepare our agencies to adapt to the new environment that comes from these patterns of change.

I’m Optimistic

Personally, I’m optimistic about the future of home care and hospice under these new reforms.  It’s been pretty clear that legislators on both sides of the aisle speak in favor of home care and hospice. The data show that is cheaper and more effective to care for patients in their homes.  Surveys show that the vast majority of folks would much rather stay at home for care then be in a facility.  That suggests that there will be real opportunity in home care going forward.

Will it be easy? Probably not.  Will it be smooth sailing? Probably not.

But three things I’ve learned in working with CEOs and C-suite leaders in home health care, hospice, and private duty home care for over three decades:

1. You are resilient
2. You are motivated by mission
3. You have great people who can help you execute with excellence

Let’s work together to make sure that health care at home comes out ahead as these changes take place.