In our new “Ask The Reader” feature, each month Provider will pose a question related to a key issue in the long term and post-acute care field. Selected answers will appear in the next issue of the magazine, while additional
responses will be posted online.

What key health care issue should the presidential candidates focus on?

Tom Coble“The key health care issue of the 2016 presidential campaign is the “Silver Tsunami,” yet we hear no candidate talking about it. The cost is not just financial—the issue also affects our workforce and delivery system. The effects are being already being felt at both the state and federal level. The candidate we elect as president is dramatically going to come face-to-face with this issue at the end of their first term (2020), whether they want to talk about it or not.”
Tom Coble, President/chief executive officer (CEO), Elmbrook Management Co.
Chair, American Health Care Association (AHCA) Board of Governors


Kris Mastrangelo“Health care reform incentivizes lower cost and higher quality across all continuums of care. Three areas that come to mind include:
1. Ensuring cost reduction without clinical compromise;
2. Retaining access to Medicare benefits for the senior population; and
3. Supporting health care providers through the transition via education, access to information, as well as proper funding.
“If we want to get more specific, we should discuss value-based purchasing and the historical successes, failures, and adaptations that have occurred in other settings.”
Kris Mastrangelo, CEO, Harmony Healthcare International
Robin Hillier“I am interested in hearing the presidential candidates focus on how to balance the desire to make health care efficient and reduce health care costs with ensuring that patients continue to receive high-quality services and have access to the providers they prefer, which is a very delicate dance. It seems currently the focus is solely on cost reduction, with quality and choice being sacrificed.
“As it relates to long term care, I would love to see the candidates discuss the need for more research related to Alzheimer’s disease, acknowledging the aging of the nursing profession, and recognizing the future reduction in the workforce available to provide care coupled with the explosion in population needing services.”
Robin Hillier, CPA, LNHA, STNA, RAC-MT, Owner, Lake Pointe Rehabilitation and Nursing Center Independent owner representative, AHCA Board of Governors

 “Alzheimer’s disease and related disorders are the costliest medical conditions we face as a nation. When you factor in all out-of-pocket dollars (estimated at $226 billion in 2015) and the unpaid care that family and friends provide (estimated at $218 billion in 2014), this half-trillion-dollar total per year is staggering. These numbers are expected to skyrocket in the next few years, unless an effective treatment is discovered.”

Dayne DuVall, LMT, CAEd, CRTS
Chief operating officer, National Certification Board for Alzheimer Care

Our question for March is, “What keeps you up at night regarding your job?”
Email your response to Joanne Erickson at, by Feb. 25.