AHCA commissioned Eljay, LLC, to compile a report on Medicaid repayments to nursing home center providers. The annual study, titled A Report on Shortfalls in Medicaid Funding for Nursing Center Care, projects that Medicaid underpayments to providers will exceed $7 billion nationally. On a per-resident, per-day basis, the average 2012 projected shortfall amount is $22.34. This is the largest shortfall reported since the inception of the study in 1999.
Highlights from the report include:
– The 2012 Medicaid shortfall is projected to exceed $7 billion nationally.
– The estimated average Medicaid shortfall for 2012 of $22.34 per Medicaid patient day is 14.3 percent higher than the preceding year’s projected shortfall of $19.55.
– For a typical 100-bed facility in which 63 percent of residents rely on Medicaid for coverage, this shortfall would mean a loss of more than $500,000 annually.
– Between 2010 and 2012, allowable costs increased an average of 4.2 percent, while Medicaid reimbursement rates only increased an average of 2.5 percent.