Nursing Home Budget Request
LeadingAge NY is urging NYS to reform and rationalize the nursing home Medicaid reimbursement methodology in the State Fiscal Year (SFY) 2025-26 budget, to ensure that Medicaid payments keep pace with rising costs and ensure access to quality care for those who need it.
THE PROBLEM
- On average, NYS's nursing home Medicaid rates cover only 75 percent of the cost of care.
- There is a $1.6 billion Medicaid funding gap for the nursing home care provided in NYS.
- The foundation of NYS's nursing home Medicaid reimbursement is based on 2007 costs.
- NYS's nursing home Medicaid reimbursement is among the worst in the country, according to an independent federal MACPAC report.
- Inadequate Medicaid reimbursement significantly hinders provider ability to compete for, hire, and retain staff.
- Lack of staff directly impacts access to nursing home services for those who need them, and contributes to hospital gridlock.
THE SOLUTION
NYS must update and reform nursing home reimbursement by:
- Increasing nursing home Medicaid rates by 20% (to combat over 50% cost growth since 2007),
- Restoring recent cuts to reimbursement for capital improvement projects, and
- Reforming the Medicaid reimbursement methodology to ensure rates match current costs, incentivize quality, and accurately reflect resident care needs. Click here to learn more about rebasing nursing home Medicaid rates.
Click here to contact the Governor, urging her to reform nursing home Medicaid reimbursement this year!
Contact: Sarah Daly, sdaly@leadingageny.org