Hello Missouri Members! Last week, at the virtual membership Annual Business Meeting, we benefitted from an illuminating overview of our field’s trends and growth from NIC’s Head of Research & Analytics, Lisa McCracken. The long-expected Baby Boom boost to the older adult population is upon us. In much of the U.S., older adults now outnumber children. Missouri’s 65+ population is up 13.2% over five years while the 75+ cohort has grown 21.6%. Moreover, with higher divorce rates among elders, the 75+ cohort is expected to double by 2040.
Lisa shared (slides here) how demographics are driving occupancy in senior communities across the nation with consistent quarter over quarter gains. National occupancy rates are pushing 90% (slightly lower in Missouri). Therefore, with occupied units at record levels, one would expect robust new construction. But new builds have been limited by high interest rates and construction costs. One result: The 75+ population growth now exceeds senior housing inventory growth.
LeadingAge members understand older adults want to remain in their homes and age there for as long as they are able. And we know that workforce availability challenges this choice. But, as the senior population expands and older adult communities reach capacity (demand outstrips supply), the decision to “age in place” will be more about necessity than choice. So, workforce challenges aside, this begs an important and paradoxical policy question: Why would federal or state governments consider cutting Medicare home health or Medicaid home & community-based services reimbursement?
Missouri HCBS reimbursement may be threatened over time by the One Big Beautiful Bill’s Medicaid spending reforms (currently a major sticking point in budget negotiations to reopen the Federal Government). The impact of those reforms will also be a topic for the Missouri General Assembly. But, more immediately, CMS’s proposed Medicare fee-for-service home health rule envisions payment cuts cumulating to 9% next year. Prior cuts caused home health providers to curtail service, and more reductions will lead to more provider departures – at the very time we need to be expanding, not shrinking, home health and care.
LeadingAge Missouri is stepping up to stop the Medicare home health cuts and support home healthcare. We have joined LeadingAge, other state affiliates, and our in-state partner, Missouri Alliance for Care at Home, in an industry opposition letter to Congressional Leadership (draft here). Also, we are encouraging our Missouri Congresspersons to co-sponsor recently introduced legislation (HR 5142) that would neutralize the proposed CMS cuts. LA MO members can support this effort with a few clicks through this Action Alert. Finally, LeadingAge and its members submitted thoughtful comments to CMS on behalf of members highlighting how its proposed cuts will negatively impact older adults by increasing emergency department visits, readmissions, mortality, and overall health care spending. LA MO members can learn more about the CMS rule, its negative impact, and opposition advocacy opportunities on the serial post dedicated to the CY2026 Home Health Payment Rule.
Collaboration among similar organizations leads to successful policy advocacy. That’s why LA MO is teaming up with others to fight the CMS home health rule. And it’s why LA MO successfully teamed up with others to stop CMS’s staffing mandate. But collaboration with others also supports LA MO membership value and ensuring the long-term viability of your association. That’s why LA MO’s Strategic Plan directs us to explore opportunities to partner or align with other LeadingAge state affiliates – an exploration motivated by the need for LA MO to grow.
LA MO routinely considers lots of growth and revenue opportunities that don’t rely on higher member dues or new members. But, for a membership organization, member growth is fundamental. LA MO serves and represents providers that deliver the full spectrum of senior living and healthcare. Do you have provider and business partners or relationships in our field that would benefit from the value of LeadingAge membership? Please consider collaborating with us to fuel the growth of your association. Let us know about Provider Member prospects (any aging services provider) and Business Member prospects (businesses that support aging services). We’ll reach out to them to grow your association and strengthen it for you!
Yours in service,
