On August 1, Montana will institute across-the-board cuts to Medicaid reimbursement rates, jeopardizing the care of thousands of seniors and people with disabilities.
Home care agencies, hospitals, mental health centers, group homes for people with disabilities and other health care providers face cuts of 2 percent — rolling back the increase they received in 2009.
Assisted-living facilities, however, will have their reimbursement rates slashed by 10 percent, reversing a 10 percent increase the state enacted two years ago as an incentive for these facilities to accept people with Medicaid coverage, reports the Billings Gazette.
The Medicaid-rate cuts will be enacted as part of legislation setting Montana’s budget for the 2012 and 2013 fiscal years, which was signed by Gov. Brian Schweitzer (D) in May.
Thousands Affected
Overall, more than 2,300 Montanans use the Medicaid waiver program to receive long-term services and supports in the “least restrictive setting” possible.
Rose Hughes, executive director of the Montana Health Care Association, which represents assisted living facilities and nursing homes in Montana, said that her organization is “very concerned that the assisted living cuts will affect access to these services for elderly Medicaid waiver clients.”
An estimated 800 Montanans covered by Medicaid live in assisted-living facilities.
Evictions Likely
Operators of assisted-living facilities say the 10 percent cut is unacceptable.
They are already losing money on Medicaid residents, they say. The cut will likely force them to evict Medicaid residents in favor of private-pay clients.
Mike White, who operates several assisted-living facilities in Montana, told NBC Montana that it is “completely unreasonable to expect facilities to stay in business when their costs are increasing and you’re cutting their revenue by 10 percent.
“How many businesses can deal with that?” White added.
Damage to Transition Program
Hughes notes that the cuts will do great damage to Montana’s “very successful” nursing home transition program, in which the state works with nursing homes to identify individuals who can successfully transition to assisted-living facilities and other home- and community-based services.
“These transitions won’t happen if assisted-living facilities are financially unable to accept these residents,” Hughes said.
Since Medicaid rates are higher for nursing homes than for assisted-living facilities, Montana will incur greater costs if the transition program is weakened.
Amendment Affects Direct-Care Workers
Meanwhile, the budget legislation included an amendment appropriating funding for pay increases and bonuses for direct-care workers employed by Medicaid-funded nursing homes and community-based services.
The appropriation, however, will be $500,000 less than in the previous biennium.
“We are obviously pleased that the Montana Legislature chose to renew the appropriation for direct care wages that was set to expire,” even at a lower rate than in previous years, said Mike Hanshew, director of policy for Consumer Direct Personal Care, a for-profit home care company with locations in Montana and seven other states.
However, because of the cuts to Medicaid reimbursement rates, direct-care workers will likely see no direct benefit from that appropriation, he added.
Medicaid-funded in-home service agencies such as Consumer Direct Personal Care will have difficulty doing “anything more than maintain our current levels of services and direct-care worker compensation,” Hanshew said.
– by Matthew Ozga




