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Nursing Home Payment and Finance

We advocate for Medicare and Medicaid payment systems for nursing homes that will appropriately account for essential costs of high quality care. We work with the Centers for Medicare and Medicaid Services (CMS) to obtain the most up-to-date information on payment policies and updates.


Featured Content

HCBS: Proposed Rule Allows Veterans Affairs Agreements

"Use of Medicare Procedures To Enter Into Provider Agreements for Extended Care Services" is a proposed rule published in the Federal Register by the U.S. Department of Veterans Affairs (VA) on Feb. 13 that authorizes the VA to enter into agreements with adult day health care as well as other community-based extended care services and nursing homes. The proposed rule states that the VA’s payment under the agreement with the highest rates would serve as an incentive to encourage providers to enter into agreements with VA for the care of veterans.

Nursing Homes: MedPAC Recommends No 2015 Payment Update

In its recent report to the U.S. Congress, the Medicare Payment Advisory Commission (MedPAC) projected Medicare payment margins among skilled nursing facilities will average 12% in 2014. Based on the size of those margins, without taking account of the continuing 2% sequestration, MedPAC recommended that Congress cancel the payment update that is supposed to take effect on October 1, 2014. Given sequestration and MedPAC's finding that total nursing home margins, including Medicare, Medicaid and private pay, average 1.8%, we will urge Congress to allow the payment update to take effect as scheduled under current law.

Positioning Yourself in a Managed Care/ACO World

Cheryl Phillips, our senior vice president of advocacy, takes a look at how LeadingAge members should be positioning themselves for the new world of integrated systems of care. Learn about the 3 major measurements the payors and health care systems will be looking at.

Managed Care: New York Times Article Reminds Us of Principles

Dr. Cheryl Phillips, our senior vice president for policy and advocacy, reflects on a recent New York Times article about Medicaid managed care and relays our principles around the topic. 

Skilled Nursing Facility Medicare Rate Calculation Tools Update

We have updated the Medicare Part-B rate calculation tool for final rates reflecting provisions of the Bipartisan Budget Act signed into law in December, 2013. The law allowed for a 0.5% average increase in Medicare payment rates and extended the 2% sequestration cut for all health care providers for another 2 years. Access to this tool requires login via My.LeadingAge.