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 State of the States Clearinghouse

 

​One stop shop for key Medicaid and Medicare information.

 

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 Medicaid Shortfall Reports

 
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Medicaid Shortfall Report

2016 Shortfall Report – Preliminary Results

AHCA commissioned Eljay, LLC and Hansen Hunter & Company P.C. to compile Medicaid payments to nursing center providers.


>> Download preliminary numbers



2015 Medicaid Shortfall Report

AHCA commissioned Eljay, LLC and Hansen Hunter & Company P.C. to compile a report on Medicaid payments to nursing center providers. The annual study, A Report on Shortfalls in Medicaid Funding for Nursing Center Care, estimates the nation’s Medicaid shortfall – over $7 billion in 2015. On a daily basis, this shortfall is $22.46 per Medicaid patient, per day which is 6 percent higher than the 2014 projected shortfall, at $21.20.

 

Highlights of the report include:

  • The 2015 Medicaid shortfall is expected to exceed $7 billion nationally.

  • The estimated average Medicaid shortfall for 2015 of $22.46 per Medicaid patient day is a 6.0 percent increase over the preceding year’s projected shortfall of $21.20.

  • For a typical 100-bed facility in which 63 percent of residents rely on Medicaid for coverage, this shortfall would mean a loss of more than $1,415 dollars each day, exceeding $516,000 annually.

  • On average, Medicaid reimbursed nursing center providers only 89.4 percent of their projected allowable costs incurred on behalf of Medicaid patients. This means that for every dollar of allowable cost incurred for a Medicaid patient in 2015, Medicaid programs reimbursed, on average, approximately 89 cents.


​​​​​​​​​  Download full report>

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