The gap between the cost of nursing home care and Medicaid reimbursement rates to such facilities has led many to close or downsize, President and CEO of nursing home association LeadingAge Wisconsin John Sauer told the Wisconsin State Journal.
“We’re losing ground,” said Mr. Sauer. “Over time, we could see an access problem.”
The study, which is from the American Health Care Association, found Wisconsin has the largest gap between nursing home cost and Medicaid reimbursement, out of the 33 states included in the analysis.
In 2015 Medicaid’s payment to nursing homes was $167.85 per person per day, $52.83 less than the daily cost of care of $220.68, according to the report. The state’s low Medicaid rates have forced nursing homes to charge private payers about $100 per day more for the same level of care.
In a separate study by LeadingAge Wisconsin, researchers concluded the state’s Medicaid payment gap resulted in a loss of $332 million at about 370 nursing homes from 2014 to 2015, or about $1.1 million at an average 100-bed facility, according to the Wisconsin State Journal.
Claire Yunker, a spokeswoman for the state Department of Health Services, said the study exaggerates the losses incurred by nursing homes and fails to fully account for their administrative costs. She added that when Medicare and patients with private insurance are factored in, most nursing homes in the state break even or even achieve a small profit, according to the report.
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