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Nursing Facility Provider Payment Principles: Review of Recommendations and Draft Chapter for March Report

In this session, staff presented a draft chapter for the March 2023 report to Congress with two recommendations following the Commission’s discussion of nursing facility provider payment principles in December 2022. The recommendations call for improved transparency of Medicaid payments and costs, as well as regular state rate studies to assess whether payment policies are consistent with statutory goals. The Commission approved these recommendations on Friday, January 27, 2023.

The draft chapter also summarizes the Commission’s prior work on nursing facility payment policy and the Commission’s payment principles that:

  • payment rates should cover the costs of economic and efficient providers;
  • payment methods should incentivize better quality and reductions in health disparities; and,
  • states should aim to get the maximum value for the amount they are spending.