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Las Vegas, U.S.A. — Nevada nursing homes and the patients under their care face $20 million cumulative reduction in Medicare funding in 2013-14 as a result of several different federal budgetary actions and regulatory payment changes made by Congress and the Centers for Medicare and Medicaid Services (CMS) since 2009, a new 50 state data analysis projects.
Nationally, nursing homes and the patients under their care face nearly $4 billion in reductions in 2013-14, and a staggering $65 billion reduction over 10 years, according to the independent health policy advisory firm, Avalere Health. Nursing homes, technically referred to as skilled nursing facilities (SNFs), are Nevada’s second largest health facility employer.
In differentiating the impacts of different budget cuts and regulatory payment changes that result in less cumulative government funding, the Avalere analysis, funded by the Alliance for Quality Nursing Home Care, will be utilized to help inform Nevada policymakers how the successive battery of federal funding reductions undermine facility operations, disrupt staffing, and threaten seniors’ care amid the growing influx of older, higher acuity patients – increasing numbers of whom are able to return home after successful rehabilitation.
The Avalere analysis, the first retrospective national and state-by-state look at recent reductions in Medicare payments to facilities, projects the 2013-14 budgetary impact on Nevada based on the following major government actions since 2009: Affordable Care Act (ACA) productivity adjustment ($7 million cut in 2013); Case-Mix Adjustment in FY 2010 CMS Rule ($7.3 million regulatory reduction in 2013); Forecast Error Adjustment in FY 2011 CMS Rule ($1.3 million regulatory reduction in 2013); Sequestration provision of Budget Control Act ($4.3 million cut on January 1, 2013 ); Bad Debt provision in March 2012 Middle Class Tax Relief and Job Creation Act ($2.1 million cut 2012-14 beginning October 1, 2012 ).
Alan G. Rosenbloom, President of the Alliance, said that with approximately 70 percent of facility expenses related to staffing, the impact of federal Medicare cuts combined with a fragile state Medicaid system causes significant difficulties in regard to hiring and retaining the direct care staff that help make a significant difference in care quality and patient outcomes.
“More Medicare cuts from Washington – which are imminent — undermine Nevada facilities’ ability to continue sending more and more patients home as quickly as possible. The unintended consequences of these cuts and regulatory payment changes will affect patient access, quality and require that care increasingly be rendered in settings that actually increase the cost to government.
This makes no sense, and is wrong for seniors, providers, taxpayers and the future of our entire U.S. health care system. We respectfully urge Nevada candidates for federal office to address how they would help stop more Medicare cuts for the state’s skilled nursing facilities and the seniors under their care.