Will N.J.’s Shift Toward Private Medicaid Program Affect SNF Reimbursements?

Nursing homes in New Jersey could potentially be in for a big chance as the state seeks to further privatize its Medicaid program. A plan to hand over the reigns of the long-term care portion of its Medicaid budget to the four insurance companies that currently manage the rest of the state’s healthcare programs for the poor is awaiting government approval.

This could curb rising Medicaid costs in nursing homes, reports North Jersey’s The Record, and divert more funding toward services and equipment for people who want receive care in their homes.

In theory, because care at home is cheaper than at nursing homes, insurance companies would have a financial incentive to create more home-based services.


“The goal is to provide care in a fully integrated setting and to create more long-term services and supports in the community,” said Lowell Arye, deputy commissioner for the state Department of Human Services. The state does not have projections about how much money will be saved on nursing home care or diverted to home care services.

The nursing home industry is not opposing the plan, though it is concerned about whether Medicaid reimbursement rates will be cut further. The industry sees the shift to managed care as inevitable.

“We recognize that this is a trend that’s happening across all of the health care system,” said Paul Langevin, president of the Health Care Association of New Jersey, an industry trade group.


However, there is concern by some that this movement away from institutional care in favor of home-based care won’t actually be cost-effective, The Record continues. Hospitals are discharging patients into nursing homes sooner in an effort to cut down on long, costly stays, and skilled nursing facilities are also caring for people with chronic illnesses and conditions where they require extensive, around-the-clock care—something that’s not cheap to provide in individual home settings.

Read the full piece here.

Written by Alyssa Gerace

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