Medicaid underpayments to skilled nursing facilities are reported to exceed $7 billion in 2012, the largest deficit since the study of this data was first started.
“Long term care insurance will become known as nursing home avoidance insurance,” predicts Jesse Slome, executive director of the American Association for Long Term Care Insurance, the national trade group based in Los Angeles, CA. “Medicaid already underpays for every patient and the pending Federal budget talks are only going to make matters worse.”
According to the study released by the American Health Care Association, the average shortfall amounted to $22.34 per patient day. “For a two year nursing home stay, Medicaid is underpaying by $16,300 an amount that nursing homes expect to cover from payments from private-pay patients,” Slome explains. “That’s an unsustainable model and people will understand that inevitably there will be two classes of care, one for those with the ability to pay and the other who must depend on whatever government programs exist at the time.”
The estimated typical Medicaid shortfall for 2012 of $22.34 per Medicaid patient day was reportedly 14.3 percent higher than the preceding year’s projected shortfall of $19.55 the report notes. Researchers point out that for a typical nursing home facility with 100-beds where 63 percent of residents rely on Medicaid for coverage, this shortfall would mean a loss of more than $500,000 annually.
“It’s not an ideal situation but it’s a real issue and unless the taxpaying public has a significant change of heart and chooses to pay more taxes to cover all the future needs of Medicare and Medicaid, the shortfall will only grow,” explained Slome. The national long-term care insurance expert noted that as awareness of the issue grows, people will realize that even a basic amount of long-term care insurance can help them avoid becoming dependent on family members or a deficient government program.
“We have millions of people who have no plan in place, find a million excuses for procrastinating and then are forced to depend on whatever government programs exist.” Slome adds, urging the membership of the organization to play a role in educating the American public.
Consumers seeking information on long term care insurance costs or looking to connect with a designated professional can do so via the organization’s website or should call the Association at (818) 597-3227. Established in 1998, the American Association for Long-Term Care Insurance is the national association serving insurance and financial professionals who provide long-term care financing solutions.
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