Payment-to-cost ratios varied based on nursing home type and staffing levels, with not-for-profit homes having the lowest ratios.
The purpose of this research was to understand the relationship between state Medicaid payment rates to nursing homes and those facilities’ costs of providing care to Medicaid residents.
Using 2019 Medicaid payment data collected from individual states and Medicare Cost Reports for freestanding nursing homes in 44 states, we calculated the national average and median per diem Medicaid payment rates, per diem costs of caring for the Medicaid population, and the Medicaid payment-to-cost ratios. 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
Assessing Medicaid payment rates and costs of caring for the Medicaid population residing in nursing Homes: Final report. (2024, October 11). ASPE. https://aspe.hhs.gov/reports/assessing-medicaid-payments-costs-nursing-homes
LeadingAge. (2024, October 16). ASPE report: Medicaid payments to nursing homes average 82% of costs of care. https://leadingage.org/aspe-report-medicaid-payments-to-nursing-homes-average-82-of-costs-of-care/
In case you missed it: New HHS report reveals significant Medicaid shortfall for nursing homes. (n.d.). https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/ICYMI-New-HHS-Report-Reveals-Significant-Medicaid-Shortfall-Nursing-Homes.aspx
Stulick, A. (2024, October 18). National study confirms Medicaid payments fall short of costs, shows links to staffing levels and ownership. Skilled Nursing News. https://skillednursingnews.com/2024/10/national-study-confirms-medicaid-payments-fall-short-of-costs-shows-links-to-staffing-levels-and-ownership/
Berklan, J. M. (2024, October 18). Report reveals how Medicaid payments stack up against nursing homes’ cost of care – McKnight’s Long-Term Care News. McKnight’s Long-Term Care News. https://www.mcknights.com/news/report-reveals-how-medicaid-payments-stack-up-against-nursing-homes-cost-of-care/
Siddiqi, Z.. (2024, November 21). Medicaid payments fall far short of covering care costs at nursing homes. Skilled Nursing News. https://skillednursingnews.com/2024/11/medicaid-payments-fall-far-short-of-covering-care-costs-at-nursing-homes/
Improve Medicare Advantage reimbursements with payer contract management that puts payer rules in the hands of clinicians & billers.
