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APHA Scientific Session and Event Listing

Recorded presentation

James H. Swan, PhD¹, Kathy Dreyer, MS¹, Joan Marie Covert, BS¹, and Charlene Harrington, PhD². (1) Department of Applied Gerontology, University of North Texas, AGER P.O. Box 310919, Chilton 238F, Denton, TX 76203-0919, 940-565-3450, kdreyer@pacs.unt.edu, (2) Social and Behavioral Sciences, University of California San Francisco, 3333 California St., Suite 455, San Francisco, CA 94118

Medicaid nursing facility payment has been of major concern: because of threats of cutbacks and of the consequences of such cutbacks for access and quality; and because of its implications for state fiscal health. State fiscal shortfalls had threatened Medicaid policy generally in 2003-2004; and both expanding Medicaid rolls and federal constraints have since promised to continue the pressure on such policy. The question is how much such pressures have actually influenced state Medicaid policy for NFs, among all other Medicaid services, and more-specifically how they may have influenced reimbursement policy. We report newly-available data on Medicaid NF reimbursement rates for 2003, placing the data in the context of data for earlier years. In constant dollars, average daily rates across states changed only 1.7% between 2002-2003, one of the lowest rates of increase on record. More importantly, freezes and decreases in NF rates for 2003 over 2002 matched or exceeded historical records for annual change since 1978. We conclude that recent Medicaid nursing facility reimbursement cutbacks are severe and unprecedented, and that they are likely to continue unrelieved for the foreseeable future.

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