NURSING HOMES: Lobby Supports Transfer Of Medicaid Funds
The American Health Care Association, a national nursing home lobby, "is proposing that the federal government move the money it pays to nursing homes each year ... from the Medicaid to the Medicare budget," the Oklahoma City Daily Oklahoman reports. At the heart of the issue lies the association's desire to separate policy issues of "poverty from aging and long term care." The association believes the transfer of Medicaid funds, about $42.8 in 1995, to Medicare "would allow people considering nursing home care to qualify for government help without losing personal assets." Currently, about "three-fourths of all nursing home residents in Oklahoma" are supported by Medicaid, with state appropriations paying "30% of the Medicaid dollars that go to the state's nursing homes." The average annual price of long term care in Oklahoma is $25,000, compared with $41,000 nationally.
The Oklahoma Nursing Home Association is debating the national group's proposal as the state "advances toward a major reform in its financing of nursing home care," according to spokesperson Mike Sulzycki. The Oklahoma Health Care Authority is charged with creating "a managed care system of paying for nursing home care by July 1, 1999." Garth Splinter, director of the state agency, has proposed a capitated system. According to the Daily Oklahoman, Splinter "wants to create something like an insurance policy rider that could be sold to Medicare or to a third party administering a Medicare capitated plan." The third party could "use the Medicaid rider to pay for nursing home care if needed or for a less expensive form of care such as home health or assisted living." Such a system "would remove state government at least one step from being the decision-maker in purchasing nursing home care," according to Splinter.
Protecting The Poor
Splinter said the nursing home capitated system he is considering would leave poverty guidelines intact but would require more state coordination with the Medicare system Splinter "can't see a day when Medicaid will be separated from poverty guidelines." He said, however, that a "switch to managed care systems ... could mean the state will eventually let go of nursing home financing and allow market forces to control the flow of dollars to the industry" (Peterson, 3/15).