DOGE, or the Department of Government Efficiency, has been making the biggest splash in Washington, D.C. these days in terms of attention-grabbing headlines, and it appears it will try to target waste, fraud and abuse in Medicare and Medicaid spending as part of its efforts. Such a move could have a major impact on thousands of facilities’ bottom lines and could change how SNFs do business if reimbursement rates are affected.
That is a major dark cloud hanging over the industry, but there are way too many unknowns to even properly prepare for what’s to come. Because, what is to come? Would DOGE’s efforts go beyond just “waste, fraud and abuse,” which should be rooted out? Will the upcoming budget negotiations between the Republican House and Senate lead to significant spending cuts in the form of reimbursement reductions? The Trump administration has been cautious about any “cuts” to entitlements, and to get moderate Republicans to vote on a budget bill with their narrow House majority, most likely cuts would have to be limited to “waste, fraud and abuse,” which has popular appeal. And Dr. Oz has yet to be confirmed as the head of CMS and would have some say in the direction of cuts.
So the actual financial impact on long-term care is a real mystery, and the industry can at least relish in the likely death of the minimum staffing mandate, for now. But could the scrutiny on government efficiency actually highlight the skilled nursing and assisted living sectors as real cost savers in the post-acute care continuum and in the healthy aging of America? One can hope.
