Medicaid
Medicaid is a program run by the states as per the federal requirements. Both the federal and state governments fund the program. It provides comprehensive health coverage to several Americans, including pregnant women, children, low-income adults, people with disabilities, and elderly adults. Medicaid was meant to reduce the financial burden among its beneficiaries. However, currently, the various healthcare facilities and health care services utilizing Medicaid are facing hardships. As of now, most physicians are quite reluctant to handle Medicaid patients.
Medicaid has caused hardships on nursing homes that care for the elderly. Some of the ways through which Medicaid causes hardships as highlighted by Ubel (2020) include;
- Low reimbursement rates. Medicaid payouts are about 61% of Medicare payouts, and it varies from state to state. Therefore, in some states, the rates are meager. These have led to discouraging incentives among nursing home physicians and lack of enough operational capital. Most of the Medicaid patients require intensive care which is not reflected by the reimbursements.
- Unacceptable waiting times to receive the reimbursements. In addition to the low reimbursement rates, there is lots of paperwork when filing for the Medicaid reimbursements leading to a month or so delays.
The Obamacare act increased the Medicaid eligibility for low-income adults. However, the expansion of Medicaid in nursing homes can affect their finances by reducing patient volume proportion and unreimbursed expenses due to uninsured patients, while raising facility income from the newly covered patients. The leading cause of financial losses among facilities utilizing Medicaid is uncompensated care and low reimbursement rates. Medicaid patients usually require intensive care; however, the reimbursement rates are low, leading to facility finance losses (Ubel, 2020).
To mitigate the Medicaid financial losses, nursing homes can take various measures to curb the losses. The facilities should utilize data mining for profitability; with data mining, the facility can develop ways to improve operations and reduce costs based on forecasts. Also, facilities should improve case management by ensuring quality care services, which will reduce hospital stay; hence the Medicaid reimbursements will tally with patient care (Beckers Hospital Review, 2020).
References
Beckers Hospital Review. (2020). How Should Hospitals Work Around Medicaid Payment Cuts This Year? Beckershospitalreview.com. Retrieved from https://www.beckershospitalreview.com/finance/how-should-hospitals-work-around-medicaid-payment-cuts-this-year.html.
Ubel, P. (2020). Why Many Physicians Are Reluctant to See Medicaid Patients. Forbes. Retrieved from https://www.forbes.com/sites/peterubel/2013/11/07/why-many-physicians-are-reluctant-to-see-medicaid-patients/#3a4bf7a21045.