In case you missed it, a new study published in the Journal of the American Medical Directors Association (JAMDA) shows a clear association between higher Medicaid funding and nursing home star (NH) ratings in Care Compare. Using data from 2019, researchers from UMass Boston found higher Medicaid payment rates increased the probability of nursing homes receiving four or five-stars for the overall ratings, health inspection, and staffing domains of the rating system. In its February issue, JAMDA published the researchers’ findings with the following conclusions:“Findings suggest that inadequate Medicaid payment rates undermine NH quality and that nursing homes need to subsidize Medicaid losses with profits from other sources. Policymakers should consider the adequacy of Medicaid payment when seeking to improve quality of care for long-stay residents, as payment policy remains a critical lever for strengthening NH performance.”
“Medicaid supports the majority of nursing home residents, and this research reinforces what providers see every day: when funding is strong, quality is stronger. The study emphasizes that providers are investing government resources into their workforce and quality improvement efforts, yet Medicaid continues to fall short,”
said Clif Porter, president and CEO of the American Health Care Association (AHCA). “It is critical that federal and state policymakers protect and strengthen Medicaid funding for long term care so that our residents can continue receiving the high-quality care they deserve.”
The research underscores the troubling reality that Medicaid often does not cover the cost of nursing home care. An earlier
study by the same researchers covered by
McKnight’s Long-Care News found that “on average, Medicaid payment rates covered about 82 cents per dollar of estimated Medicaid costs in nursing homes.” The authors noted that insufficient Medicaid payments can undermine quality and strain providers’ ability to sustain operations.
Conversely in this latest study, the researchers found that higher Medicaid payments allowed facilities to direct more resources toward staff compensation, training and other recruitment and retention efforts to increase their staffing star rating. Additionally, higher payment rates meant that facilities could focus on quality assurance and improvement procedures to increase their health inspection rating. The researchers note:
“Collectively, these additional investments―in more qualified staff, enhanced training, and quality improvement initiatives―translate to higher overall star ratings.”
Investing in Medicaid is one of the most valuable tools available to support care quality and access, while cuts and underfunding disproportionately harm vulnerable populations. The UMass Boston study showcases that low Medicaid payments may unintentionally widen gaps in care for communities that rely on the program the most, including in rural areas and facilities serving more people of color.
A pillar of AHCA’s policy agenda,
The Better Way, is to protect Medicaid. To support access to care and quality improvement efforts, policymakers must prioritize and defend Medicaid funding for long term care. More than 60 percent of nursing home residents rely on Medicaid for their care, and the program is the primary source of long term care coverage for Americans. As the senior population of the United States grows rapidly, policymakers must ensure Medicaid is fully funded to meet the growing demand for long term care services and ensure that facilities are able to continue to deliver high-quality care.