NASL becomes ADVION in ‘inspired’ move; home health, outpatient services gain focus

WASHINGTON, DC — The National Association for the Support of Long-Term Care officially became ADVION Sunday night when the association of ancillary services providers unveiled its new name and expanded focus at its annual meeting.

Long respected for its astute advocacy work on behalf of skilled nursing ancillary services providers, the group is intent on further expanding its reach into home health and outpatient rehab therapy settings, said Cynthia Morton, the group’s executive vice president, in a 1-on-1 interview with McKnight’s Long-Term Care News.

“We’re very well known for our advocacy in the nursing facility space. But our members have evolved. They operate in many other settings,” she explained. “[Patients] may receive services in nursing facilities or go home with home health or go home and see an outpatient clinic once or twice a week. Our association needed to evolve to continue to meet their needs and to continue to be relevant because long-term care has evolved.”

Most proud for its role in getting the Medicare Part B therapy caps repealed in 2018, ADVION also happily points to its getting Congress to mitigate payment cuts for certain therapy services the last two years.

While there will be additional attention given to home health and outpatient services, it will also still mean full focus on electronic medical records development, portable X-ray services and certain lab services for skilled nursing providers and others previously attended to, Morton emphasized. 

One of ADVION’s major points of focus will continue to be information technology companies that produce electronic health records.

Sara Lord, a partner with Arnall Golden Gregory LLP, and Cynthia Morton, the executive vice president of ADVION, model hats bearing the group’s new logo, which was unveiled Sunday evening.

“There is an incredible amount of synergy between what the EMR companies, the IT vendors, need to program in the nursing facility space and other post-acute care settings and with what therapy is doing because therapy is one of the key services provided, especially in post-acute care,” Morton explained. “CMS is undertaking a lot of initiatives to construct what the data package will be that follows the patient from setting to setting, so our IT companies are very closely tracking and participating in that.”

The group’s traditional points of focus will remain but simply be expanded upon, Morton stressed.

“Our core is the SNF sector and that’s ‘home,’ and will always be home and our passion,” she explained. “Many nursing facility companies have expanded into home health and various outpatient services, so NASL — ADVION — is evolving to meet those needs. We want to be out there to be the persuasive organization we’ve always been, so we need to move … where the market is.

“This is what patients demand,” she continued. “They’ve shown us through COVID they want to receive services in many different settings. And we want to be right there, advocating for the best quality care for those patients.”

Why ADVION?

The group’s new name reflects the two main traits members identify it with, Morton said: “Advocacy” and being a tireless “champion” for those it represents.

The new logo spells ADVION in all capital letters. The “O” contains a depiction of the Capitol in Washington, the place where so much of the group’s related business takes place.

While it will continue to visibly rally advocates to pressure lawmakers on various issues, much of its handiwork will take place less conspicuously, via back-channel communications and lobbying. The cumulative effects then may yield something like the monumental repeal of therapy caps, which arbitrarily limited how much therapy could be applied — and reimbursed — for 20 years.

Despite the group’s first name change in its 33-year history, some things will continue as usual, Morton said.

“It means analysis of the payment rules … developing comment letters back to CMS to tell them what we think about that home payment rule, and comments from the point of view of our members. It’s continued intelligence gathering from what’s going on on the Hill,” she noted.

“I don’t know if SNF folks understand, but the home health sector is actually facing a behavioral adjustment which is pretty aggressive from CMS, a little more aggressive than what we thought we were going to see in the SNF sector with the parity adjustment.”

What’s next with the issues

She said there’s “movement in Congress” to try to block such adjustments — or “cuts” in the vernacular of most people not drenched in the inner workings of federal legislative affairs, as ADVION and its members are. She next looks to an expected lame-duck session of Congress for any meaningful changes to become codified, after midterm elections that will determine who will be in power in 2023.

“It’s always a little bit of a food fight at the end of the year in Congress,” she explained. “Probably for the last 15 years, they’ve tended to wait until December to deal with major healthcare policies that need congressional action. This year is no different. We’ve got a midterm election coming up in November. I bring that up because it could impact the majority party’s view on what type of policies they want to include in that end of the year package.”

ADVION will be pushing for fee schedule cuts to be addressed, which she thinks will happen. The group also will be hoping for a third year of mitigation of therapy-assistant cuts specific to Part B services. 

“We have a coalition working on that. But these are just two issues that Congress is being asked to deal with. There’s at least 18 to 20 more,” she acknowledged. “If they don’t hear from us, they’re going to move on to some other sector.”

It may represent business as usual for anyone working in and around Congress. From now on, however, they’ll be dealing with a “new” group in the post-acute space, ADVION.

A newly designed website will debut in December at ADVIONadvocates.org, Morton said. Until then, the longstanding www.nasl.org will remain active.

Medicare Advantage warnings

In the annual meeting’s opening day keynote address, Fred Bentley, a principal with ATI Advisory, warned that Medicare Advantage’s growth has been astronomical and will not slow down soon.

“If an ‘asteroid strike’ like a pandemic didn’t put a dent in this, I don’t know what will,” he told the ADVION crowd. “It’s here to stay. There is some kind of limit to it, sure, but we’re nowhere near it.”

After enumerating a handful of discouraging trend lines, such as this administration’s “incredibly adversarial” relationship with the sector and crushing workforce shortages, Bentley also offered some “rays of sunshine.”

Those include the aging of the population, which “offsets a lot of the negative effects,” and several growth opportunities, such as the rise of ancillary services for home care and the pursuit of patients with more complex needs. Providers also have become creative in pursuing value-based care strategies, and by exploring more technology-based solutions, Bentley said.

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