In Unfolding Budget Debate, Alliance To Spotlight Flawed MedPAC Policy Guidance

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Seniors / Aging
Article Date: 02 Feb 2008 - 0:00 PDT

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Commenting on the January 31 New York Times news article reporting the Bush Administration's FY 2009 budget will include no Medicare funding update to help care for the growing number of seniors who need high acuity nursing home care, the Alliance for Quality Nursing Home Care said it will work in 2008 to demonstrate to Congress that Medicare funding decisions for skilled nursing facilities can be accurately determined only by taking a more expansive, complete view of the sector's operating environment.

Noting the Times article reports that "to justify prior budget proposals, the White House has often cited the work of an independent federal panel, the Medicare Payment Advisory Commission (MedPAC)," Alan G. Rosenbloom, President of the Alliance, stated, "On behalf of nursing home patients and the hundreds of thousands of caregivers who serve them, we are disappointed that again, MedPAC's flawed funding policy guidance is being adopted, and superseding the economic realities experienced by providers in the long term care marketplace."

Continued the Alliance President, "By failing to consider the substantial Medicaid payment shortfalls to nursing homes in formulating its recommendations, MedPAC provides the Administration, Congress and the public a flawed basis upon which to assess the funding landscape, and to ultimately determine the best policy."

With as much as 70% of nursing home operating costs driven by labor costs, inadequate overall funding may force nursing homes to make difficult decisions that could affect the hundreds of thousands of direct care workers in nursing homes -- 86% of whom are women, and 30% of whom are minorities. "If the direct care work force becomes further destabilized because nursing homes don't have the resources to make ends meet" he continued, "it is the patient most negatively impacted." Rosenbloom also noted that "such cutbacks would disproportionately affect low income Americans, given the significant percentage of nursing home patients and direct care workers who would be most severely impacted by the President's proposal and MedPAC's recommendations."

Consistent Medicare funding is especially important at a time when states are struggling to balance their budgets, and many states are taking steps to cut Medicaid, a trend likely to accelerate if the President's proposed cutbacks in Medicaid funding also are adopted. "Since Medicare funds help ensure adequate resources are available to support Medicaid patients in nursing homes," Rosenbloom expressed concern that "the combined impact of Medicare and Medicaid cuts could be especially devastating to the nation's poorest nursing home patients."

Rosenbloom said the Alliance will make a concerted educational effort throughout to year to explain to policymakers on Capitol Hill and executive agencies why excluding Medicaid margins in formulating Medicare funding policy skews the perception of economic reality in a manner harmful to seniors and their growing complex care needs, as well as to the direct care workers who serve them.

The Alliance for Quality Nursing Home Care
http://aqnhc.org/index.html