This presentation reviewed preliminary analyses of Medicaid nursing facility payments relative to costs based on feedback from a technical expert panel that MACPAC convened in February 2022. Although limited data are available nationally, we found that Medicaid payments varied widely by state and facility in 2019. After accounting for supplemental payments, some facilities received payments in excess of costs, but complete data on supplemental payments are not yet available for all states. The presentation also examined the relationship between Medicaid payment rates and nurse staffing levels.
The presentation concluded by discussing potential payment principles to guide future analyses of Medicaid nursing facility payment policies. Additionally, it looked at potential policy recommendations to help support the adoption of these principles, such as improved data at the federal level and support for states to conduct their own, more detailed analyses of Medicaid payments relative to costs.