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Will Ohio ever gain effective control of Medicaid costs? Not if the nursing-home lobby continues to get its way
Published on Friday, Jun 26, 2009
Ted Strickland's budget proposal called for spending $12.5 billion over the next four years on nursing homes, the time frame allowing a phase-in of complicated changes to reimbursement formulas. Nursing homes effectively argued patient care would suffer under the governor's plan, and the House added $250 million for the biennium beginning July 1.
After that, things got out of hand.
First, Republicans in charge of the state Senate added another $150 million for the two-year period. Then, they slipped into the budget plan amendments that would provide nursing homes with $13.7 billion over four years, $1.2 billion more than the governor's proposal. Worse, Republicans approved locking into state law inflation factors that starting in 2013 would give nursing homes annual increases in the future, something enjoyed by no other Medicaid provider.
The result? Efforts to shift elderly Medicaid recipients into far cheaper in-home and community-based care would be deeply undermined, popular programs such as PASSPORT, providing in-home care, falling under the knife. Thus, Ohio would continue down the rigid and wasteful path it has traveled for three decades, expensive nursing-home care consuming a disproportionate share of Medicaid spending.
As it stands, almost three-fourths of Medicaid consumers of long-term care are in nursing homes, making Ohio one of the 10 worst states in the nation for overreliance on institutional care. It is an extremely costly commitment, well above the national average of 61 percent. While nursing-home care costs $56,000 a year, in-home care costs $12,000.
Strickland would roll back the House and Senate increases for nursing homes, declining, too, to set into motion automatic inflation-based increases. The nursing-home lobby has responded with its usual fervor, predicting restricted access to needed care, closed homes, thousands jobless, patients' health damaged by transfers to other facilities.
Even advocates of in-home and community-based care would allow some flexibility for increased costs that can be tied directly to patient care, the same concern that led the House to makes its $250 million adjustment. But going beyond that cannot be justified, Ohio drifting farther and farther away from effective strategies, widely used in other states, that serve the elderly and save money.
Get the full article here.
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Posted 07:19 AM, 06/26/2009
"Nursing homes effectively argued patient care would suffer under the governor's plan, and the House added $250 million for the biennium beginning July 1."
Do you really believe that? The nursing home lobby didn't effectively argue for anything....they made huge campaign contributions to legislators from both parties. Pay to play is alive and well!
