December 15, 2011
Eljay, LLC (Eljay), was engaged by the American Health Care Association (AHCA) to work with its state affiliates and other sources to compile information on the shortfall between Medicaid reimbursement and allowable Medicaid costs in as many states as feasible. This year’s compilation, like in the previous nine reports, identifies the shortfall for the latest year for which audited or desk-reviewed cost reports were available, which for most states was 2009. The estimated average shortfall in Medicaid reimbursement slightly decreased from $16.79 per Medicaid patient day in 2008 to $16.54 in 2009. The estimated 2011 projected shortfall climbed significantly to $19.55. Eljay estimates that state Medicaid programs, on average, reimbursed only 90% of projected allowable costs incurred on behalf of Medicaid patients in 2011, the second lowest percentage since the inception of this study.