Topic:
The speakers present new information on the relationship between Medicaid nursing home reimbursement rates and the reported costs of care. Medicaid is the primary payer for nursing home care, covering over 60% of all nursing home residents on a typical day. Any public reimbursement system requires a balance between providing adequate reimbursement and being financially prudent with taxpayer dollars. Setting nursing home reimbursement rates too high can lead to excess profits at the expense of taxpayers. At the same time, in order to invest in nursing staff and other quality improvement efforts to assure proper care, nursing homes need to be appropriately reimbursed.
An independent assessment of Medicaid reimbursement and the cost of caring for Medicaid-reimbursed nursing home residents is needed to determine if Medicaid reimbursement rates are in line with the costs of providing care. This study, funded by the U.S. Department of Health and Human Services, does this by analyzing state Medicaid nursing home reimbursement rates and care costs on a facility-by-facility basis across the country. The study found that for each dollar a nursing home spends providing care to a Medicaid recipient, the average nursing home receives just 82 cents in reimbursement. https://aspe.hhs.gov/reports/assessing-medicaid-payments-costs-nursing-homes
About the Speakers:
· Edward Alan Miller, PhD, MPA is Professor and Chair, Department of Gerontology, Fellow, Gerontology Institute, Manning College of Nursing and Health Sciences, University of Massachusetts Boston; Adjunct Professor, Department of Health Services, Policy, and Practice, School of Public Health, Brown University; Editor-in-Chief, Journal of Aging & Social Policy. His research focuses on understanding the determinants and effects of public policies and practices affecting older adults in need of long-term services and supports. He is author/co-author/editor/co-editor of more than 151 journal articles, 22 book chapters, and 9 books.
· Marc A. Cohen, PhD is Clinical Professor, Department of Gerontology, Fellow and Co-Director, LeadingAge Long Term Services and Supports Center, Gerontology Institute, Manning College of Nursing and Health Sciences, University of Massachusetts Boston. Prior to joining UMass in the fall of 2016, Dr. Cohen served as the Chief Research and Development Officer and former President and co-founder of LifePlans, Inc., a long-term care research and risk management company. Dr. Cohen has conducted extensive research on public policy issues affecting the financing and delivery of long-term care services (LTSS) and has influenced LTSS policy in his many roles. For example, he has testified before Congress and other organizations, served on Governor Patrick’s Task Force on LTSS Financing for Massachusetts, was a Steering Committee member of the Long-Term Care Financing Collaborative, and served as a Chair for a National Academy of Social Insurance Study panel on Designing State-Based Social Insurance for LTSS.
· Elizabeth Simpson, MPH is Doctoral Student, Department of Gerontology, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, and Managing Editor of the Journal of Aging and Social Policy. She has played a key role in research projects on LTSS.
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When: April, 2025 02:00 PM Eastern Time (US and Canada)
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