MAJOR STUDY FINDINGS ON THE ASSOCIATION BETWEEN MEDICAID PAYMENTS AND COSTS
2024
Medicaid Payments and Nursing Home Costs
publication
Author Information
Author(s): Edward Miller, Marc Cohen, Elizabeth Simpson, Sara Karon, Iara Oliveira, Judith Dey, Marie Squillace, John Bowblis
Primary Institution: University of Massachusetts Boston
Hypothesis
The study investigates the relationship between Medicaid payment rates and nursing home costs.
Conclusion
Medicaid payments often do not fully cover nursing home costs, with significant variations based on ownership type and quality ratings.
Supporting Evidence
- In 2019, Medicaid payment rates covered about 82 cents per dollar of estimated nursing home reported costs.
- 40% of nursing homes had Medicaid payments covering 80% or less of their reported costs.
- Not-for-profit nursing homes had the lowest Medicaid payment-to-cost ratio at 0.76.
- Nursing homes with the highest Medicaid payer mix had a higher payment-to-cost ratio of 0.86.
Takeaway
This study shows that nursing homes often don't get enough money from Medicaid to cover their costs, especially if they are not for-profit.
Digital Object Identifier (DOI)
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