By Steve Moran

I am writing this the morning of the first 2024 presidential debate and thinking about the impact of the November general election. The presidential contest is a doozy, with most Americans wishing we had a completely different set of candidates. But as consequential as the presidential election is, ultimately, the totality of the outcomes has the potential to significantly impact senior living.

High Stakes

Right now it feels like the stakes are massive, and maybe that will turn out to be true, though we often overestimate and over hype these things.

At the NIC Fall Conference there will be a discussion about the impact of the election on the country and on the senior living sector. (Foresight is a media partner with the conference.) The conversation will be between NBC’s chief political analyst Chuck Todd and former U.S. secretary of health and human services Mike Leavitt.

What I Am Hoping to Hear

Here are the things that seem most consequential to senior living right now:

  • What happens if we have a divided government, as exists today?
  • What happens if we have a single party in control (president, House, Senate), and how different it will be if Republican or Democrat?
  • What is going to happen with the Social Security system, as we get ever closer to the well being dry?
  • Same question for Medicare.
  • What’s next for the nation’s health care system as the population ages?
  • A look at the current regulatory system: Should we expect more regulations or less?
  • What will happen with immigration?

Perhaps these are the biggest topics:

Value-Based Care

The discussion will include the topic of value-based care. There is a push to implement it for all Medicare beneficiaries by 2030. The big idea is that it will improve the quality of care, provide better access, and reduce costs.

The big question is what role senior living will play in the new value-based care world.

Transparency and Accountability

There is a growing push for more accountability and transparency in the entire health care system. Specifically in the nursing home sector, there is a lot of talk about how related-party transactions make it difficult or impossible to really understand nursing home profitability, or lack of profitability. Wrapped into this question is quality of care. There is a general perception in the marketplace that the quality of care, particularly in nursing homes, is not good enough.

Minimum Staffing and CMS

CMS recently announced new staffing rules that the industry hates and that the nursing home reformers say don’t go far enough. On top of that, significant parts of the rules are head scratchingly nonsensical (specifically the rules around LPNs).

The Role of Private Capital

Capital is critical to senior living, and there is fresh scrutiny of REITs and private equity in the sector, with the assertion that these investors only care about profits and not about people. This means a push for more oversight and potentially more regulation.

I would love to hear your thoughts about these big issues, and I hope to see you at the NIC Fall Conference in Washington DC. A quick reminder that early bird rates end August 1, when the rates jump by $700.