LeadingAge: NFCs Need Medicaid Rate Increase and Payers Structure Overhaul

Qualified Nursing Facilities Need Increased Medicaid Reimbursement Rates To Pay For Increased Caregiver Compensation, As Well As An Overhaul Of Current Payor Structure, Says Six-Strategy Vision Report from the senior care advocacy group LeadingAge.

LeadingAge released the report, “Feeling Valued Because They Are Valued,” on Thursday, a timely push as Congress debates President Joe Biden’s $ 2,000 billion US jobs plan proposal. The document details the organization’s long-term vision for the industry.

Medicaid is the largest public payer in the long-term services and supports (LTSS) funding system, accounting for 57% of national spending, researchers Robyn Stone and Natasha Bryant said in the report.

Operators must also commit to tying the rate hike to the salaries of nursing assistants, the report notes. State establishments that increased reimbursement rates between 2019 and 2020 increased salaries slightly, often without keeping pace with inflation.

Qualified nursing facilities have faced warrants in some states for an increase in the minimum wage, which were not associated with adequate increases in Medicaid reimbursement rates, the report continues.

“To remedy this situation, several states have adopted ‘wage shifting’ measures requiring providers to use any new Medicaid payments to increase staff salaries,” the report said. “These approaches are not as effective as they could be because they have limited timeframes, have not been sustainable and have been difficult to implement when consumers hire assistants directly, rather than through the intermediary. of an agency. “

LeadingAge suggested completely reforming the funding system by exploring social insurance approaches to funding LTSS. The researchers said the current system is unsustainable if Medicaid continues to be the primary source of funding.

The organization cited Washington State’s new social insurance program as a model for the future. Established by the Long-Term Care Trust Act, the state funds the program with a payroll tax of 0.58% which translates into a payment of $ 36,500 per person needing LTSS dollars.

“Injecting insurance dollars into the LTSS system can provide additional and more consistent funding which, in part, can help ensure more adequate wages for the LTSS workforce,” the researchers said, adding that other bills submitted to Congress would displace the payment. from the Medicaid safety net approach to a social insurance concept.

The remaining strategies included in the report suggest expanding the pipeline of caregivers; an emphasis on education and training; facilitate professional advancement; and prepare workers for multiple contexts across the continuum of care. According to LeadingAge, caregivers should receive cross-training in assisted living, senior housing and home care, in addition to nursing homes. The national organization represents more than 5,000 nonprofit aging service providers.

“The COVID pandemic has shed new light on the value of these professionals, but also made it clear that America does not have the infrastructure for the aging services we need,” said Katie Smith Sloan, president. and CEO of LeadingAge, in a statement. “Social workers such as licensed practical nurses, orderlies and home health aides are at the heart of aging services. This vision paves the way for a sustainable and redesigned workforce of professional caregivers that our country needs to provide better care to millions of older Americans. “

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