MedPAC Misses the Mark When Assessing Nursing Home Needs, Alliance Says |
|
|
|
Written by U.S. Insurance News
|
|
Thursday, 13 December 2007 |
The Medicare Payment Advisory Commission (MedPAC) has made a draft recommendation for skilled nursing facilities for Congress, and the Alliance for Quality Nursing Home Care thinks its assessment falls way short.
The Medicare Payment Advisory Commission (MedPAC) has made a draft recommendation for skilled nursing facilities for Congress, and the Alliance for Quality Nursing Home Care thinks its assessment falls way short.
MedPAC has recommended that skilled nursing facilities should receive no inflationary market basket update for 2009. The Alliance calls MedPAC’s evaluation “incomplete and far off the mark” in terms of providing lawmakers with the overall economic picture they need to make budgetary decisions that affect the care of America’s seniors—and their caregivers.
“When assessing the adequacy of Medicare funding for the nation’s nursing home residents, and making subsequent recommendations to Congress, MedPAC should be obligated as a matter of basic responsibility to consider the overall economic conditions in which the sector operates,” said Alan G. Rosenbloom, president of the Alliance.
Rosenbloom pointed out that Medicaid pays for nearly two-thirds of patients in the country’s nursing homes, but pays less than the actual cost of care.
According to a study by BDO Seidman recently released by the American Health Care Association, Medicaid pays about $4.4 billion less than the actual cost of nursing home care for seniors. This means it pays $13.15 per patient per day less than the cost of care—an amount that has increased 45 percent since 1999.
“Adequate Medicare payments are essential to maintaining the financial stability essential to ensure the quality of care provided to millions of seniors is optimal,” Rosenbloom said.
In making its draft recommendation, MedPAC acknowledged the shortfall in Medicaid funding and the fact that overall operating margins for nursing homes are low. Tthe committee, however, still based its recommendations exclusively on Medicare performance.
In some nursing homes, labor costs make up as much as 70 percent of overall operating costs. Therefore, inadequate overall funding may force nursing homes to make crucial personnel decisions.
“If the direct care work force becomes destabilized because nursing homes don’t have the resources to make ends meet, it is the patient who may suffer the most,” Rosenbloom observed.
Adding to the gloomy assessment of the situation is a recently released report from the National Governors Association, which says that many states are facing budgetary shortfalls due to rising costs of health care and the housing crisis. Thus, shortfalls in Medicaid payments could worsen.
Rosenbloom concluded, “While MedPAC has opted to ignore both the broader marketplace realities and the looming impact of adverse state budget trends, we believe Congress should take a more expansive view to assure the stability of the direct care work force and the quality of care for all nursing home patients.”
|
