Say No to Cost-Sharing for Skilled Nursing Payments, Alliance Says

Proposals to shift skilled nursing facility (SNF) Medicare costs to beneficiaries themselves could lead to unfavorable unintended consequences, the Alliance for Quality Nursing Home Care said this week.

The Alliance, a coalition of 12 post-acute and long term care organizations warned that recent cost-sharing proposals could have “serious unintended consequences,” such as an increase in re-hospitalizations after patients avoid SNF stays, which would ultimately drive Medicare costs upward.

“Previous research suggests any savings that result from imposing additional out-of-pocket costs on beneficiaries must be weighed against the additional costs likely to occur in other areas of the Medicare system—particularly hospitalizations—that could increase Medicare expenditures in those areas while leading to poorer outcomes for beneficiaries,” said Alan G. Rosenbloom, president of the Alliance. “In addition, imposing higher cost-sharing responsibilities on patients reduces both necessary and unnecessary care.”


Currently, Medicare patients do not have co-sharing obligations for the first 20 days of a SNF admission, and the Super Committee may be considering implementing a co-payment for the first 20 days of SNF under Medicare, the alliance stated. The idea behind the proposal is that the SNF co-payment would discourage medically unnecessary SNF utilization.

The current proposals to implement the SNF co-payment include a paper from the Congressional Budget Office (CBO), under which the co-payment would be $59 per day. This would shift costs to patients while reducing federal Medicare spending.

Written by Elizabeth Ecker