Alliance to MedPAC: Don’t Make Medicare Funding Decisions in a Vacuum

The Medicare Payment Advisory Commission (MedPAC) should make Medicare funding decisions based upon the “significant, documented underfunding of skilled nursing facility patient care by state Medicaid programs,” says the Alliance for Quality Nursing Home Care.

This recommendation was made after a recent study found the nursing home industry is existing on “razor-thin” operating margins due to substantial Medicaid funding shortfall.

“In sum, the idea that Medicare can or should look at SNF payment rates in a vacuum fails to acknowledge the practical reality that the Medicare and Medicaid populations overlap in these settings and ignores the crucial influence that Medicare rates have on improving outcomes for all patients,” said Alan G. Rosenbloom, President of the Alliance, in a statement.


“While it may make theoretical sense to assert that Medicare should pay only for Medicare beneficiaries, in practice, this vastly oversimplifies how this sector of health care operates—and misjudges how services are ultimately financed for this patient population,” he continued.

The MedPAC hearing, which was held Dec. 26, needed to have “proper historical perspective,” said Rosenbloom

“This could be a replay of the early phases of the SNF Prospective Payment System, when roughly 20% of nursing facilities filed for bankruptcy, nurse staffing levels plummeted 17 – 33%, and survey deficiencies increased significantly,” he said.


Written by Alyssa Gerace

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