The study also identifies an inverse relationship between staffing levels and Medicaid payment-to-cost ratios, with higher-staffed facilities facing a proportionally larger funding gap.
“We found that Medicaid payment rates for the average or median nursing home covered about 82 cents per every dollar of reported cost nursing homes incurred caring for Medicaid residents. For approximately 40% of nursing homes, Medicaid per diem payments covered 80% or less of their estimated per diem Medicaid costs. The majority, or 52% of nursing homes, had 80-100% of their Medicaid per diem costs covered; and the remaining 8% had payments exceeding their per diem costs. Not-for-profit nursing homes had the lowest Medicaid payment-to-cost ratio compared to for-profits and government-owned nursing homes.”
Bowblis, John R., et al. Assessing Medicaid Payment Rates and Costs of Caring for the Medicaid Population Residing in Nursing Homes: Final Report. ASPE, U.S. Department of Health and Human Services, 11 Oct. 2024. https://aspe.hhs.gov/reports/assessing-medicaid-payments-costs-nursing-homes
In Case You Missed It: New HHS Report Reveals Significant Medicaid Shortfall For Nursing Homes
“Serving seniors is a privilege and an honor for nursing home providers across the country, but in too many states, Medicaid reimbursement is not sustainable. As a country, we have a sacred duty to provide that safety net for our nation’s most vulnerable. Federal and state officials must stop shortchanging their care.” — Clif Porter, President and CEO, American Health Care Association
— American Health Care Association, October 22, 2024
“Nursing homes need adequate resources to recruit and retain nursing staff and to implement quality improvement efforts to assure proper care. Our findings suggest that Medicaid payments for most nursing homes are alone not sufficient enough to cover the costs of caring for Medicaid residents, let alone needed investments such as these.” — Edward Miller, Professor of Gerontology and Public Policy, University of Massachusetts Boston
— Skilled Nursing News, October 18, 2024
Report Reveals How Medicaid Payments Stack Up Against Nursing Homes’ Cost of Care
“If a nursing home wants to make investments in quality improvement, whether that be [improving] staffing levels or paying workers more to lower turnover, that means they need to have adequate financial resources. And that’s not going to be feasible given the current payment models.” — John Bowblis, PhD, Professor and Research Fellow, Scripps Gerontology Center, Miami University
— McKnight’s Long-Term Care News, October 16, 2024
Study: Medicaid Reimbursements Don’t Meet Care Costs
“Greater numbers of people are retiring. They are living longer. They are living long enough to experience long-term care need. The demand for care will increase significantly. What this (study) shows is that nursing homes are struggling financially, and it would appear to me that if you want to influence better outcomes in nursing homes, then you want to ensure proper funding.” — Marc A. Cohen, Co-Director, LeadingAge LTSS Center @UMass Boston
— LeadingAge LTSS Center @UMass Boston, November 2024
