/PRNewswire/ -- A new study released today finds that Medicaid programs in states across the country underfunded nursing facility care by $5.6 billion in 2010, paying on average $7.17 per hour per patient, less than the nation's current minimum wage of $7.25 per hour. A lifeline for many elderly and disabled, Medicaid funds 64 percent of the care provided in America's skilled nursing facilities nationally.
"This report reveals a truth many would not believe – today's nursing facilities are paid less than the minimum wage," stated Mark Parkinson, President & CEO of the American Health Care Association (AHCA). "That must change if we ever hope to serve the needs of a Baby Boom generation that will only stress our care delivery system further."
Compiled by the research group Eljay -- a nationally-recognized expert in long term care -- the report identifies which states are most affected by the rising pressure on state Medicaid budgets, both in terms of highest aggregate Medicaid underfunding and highest per patient per day underfunding. States topping those lists are New York, Illinois, Massachusetts, Minnesota, New Jersey and Wisconsin.
Nursing home providers are often forced to rely on funding from other sources – primarily Medicare – to fill in the funding gaps resulting from inadequate Medicaid payments. With so many of the nation's governors facing difficult choices surrounding budget cuts, Parkinson cautioned at the danger of allowing an already squeezed Medicare system to prop up Medicaid payment rates.
"There is a vast gap between the actual cost of providing quality eldercare and what the Medicaid program truly finances," Parkinson stated. "As Baby Boomers begin to ponder their long term care needs in the future, it is simply unsustainable for Medicare to continue filling that financial gap. As current trends indicate, this problem will only grow worse in the coming years."
The following charts highlight the states with the largest aggregate Medicaid underfunding and largest per patient per day underfunding:
Largest aggregate Medicaid underfunding
1. New York - $1,396,494,595
2. Illinois - $378,779,709
3. Massachusetts - $310,871,237
4. New Jersey - $304,430,314
5. California - $288,599,289
6. Pennsylvania - $277,609,403
7. Ohio - $248,513,290
8. Wisconsin - $181,237,562
9. Minnesota - $151,611,752
10. Missouri - $137,412,649
Largest Medicaid per patient day underfunding:
1. New York - $47.95
2. New Hampshire - $31.25
3. Massachusetts - $31.22
4. New Jersey - $29.29
5. Washington - $28.18
6. Wisconsin - $26.54
7. Minnesota - $24.70
8. Wyoming - $23.67
9. Delaware - $22.86
10. Illinois - $21.95
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Showing posts with label study. Show all posts
Showing posts with label study. Show all posts
Wednesday, January 12, 2011
Long Term Care Pharmacy Alliance Concerned with Proposed CMS Rule; New Study Confirms LTCPA Position
/PRNewswire/ -- The Long Term Care Pharmacy Alliance (LTCPA) expressed concern with CMS's proposed rule on short-cycle dispensing within the long-term care (LTC) setting. In comments submitted to CMS Tuesday, LTCPA explained that any cost savings generated by implementing a short-cycle, 7-day fill dispensing regimen, would be overwhelmingly eliminated by additional dispensing fees resulting from the quadrupling the number of dispenses needed to move from 30-day to 7-day cycles.
A study conducted by Managed Solutions, LLC and released today supports this conclusion and finds that moving all Medicare Part D prescriptions to a 7-day fill would result in increased costs to Part D payers of over $800 million annually. Even moving more expensive brand products to a 7-day fill would still increase costs to Part D payers of $154 million annually.
"While LTCPA supports the goal of reducing waste, we also recognize the need to consider all costs associated with the proposed rule, so that unintended consequences do not result from the application of the rule. Given that it's the American taxpayer ultimately shouldering the burden of paying for this statute, it is critical that calculations such as those provided in our study be factored into the drafting of regulations," stated Bill Daniel, Executive Director for LTCPA.
The study derived its analysis from information received from eight LTC pharmacies. The findings estimated the amount of unconsumed medication among Medicare Part D residents in skilled nursing facilities and the potential cost reductions that could be achieved through shorter fill times.
In addition to the increased cost to payers, other key findings included:
* "Wasteful dispensing" to nursing home residents covered by Medicare Part D, only amounts to approximately 2.9% of total dispensed value. Short cycling this percentage of waste would save only $125 million annually and cost over $900 million in additional dispensing fees. This is in stark contrast to the $712.5 million in annual savings estimated by the Congressional Budget Office in their scoring of the short-cycling provision.
* The tradeoff between reduced waste associated with unused medication and increased pharmacy operating costs due to more frequent medication dispensing only becomes favorable to the taxpayer for prescriptions with original dispensed value of over $400.
In its comments, LTCPA stated that CMS's approach on short-cycle dispensing is contrary to Congress' intent that Section 3310 of the Patient Protection and Affordable Care Act result in savings to Medicare Part D. "We believe that it was Congress' intent to decrease costs associated with unused medications for Part D residents in LTC facilities. Implementing short cycle dispensing for long term care patients with an average length of stay of 835 days who are primarily taking maintenance medications does not meet this financial goal. While we applaud CMS's initial proposal to short cycle traditionally more expensive brand products, we believe that this limitation isn't narrow enough. Our data clearly shows that there is a prescription value threshold of $400 that must be met in order to achieve any cost savings," continued Bill Daniel.
In the proposed regulations, CMS calls for data collection by Part D plans in order to study the efficiencies of various dispensing methodologies and to estimate the cost of unused drugs and possible savings. As CMS has identified their lack of data on unused Part D drugs in this population, LTCPA recommends that before drafting any final regulations CMS conduct a study to determine the causes, frequency and cost of unused medications and also consider alternatives to 7-day dispensing cycles.
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A study conducted by Managed Solutions, LLC and released today supports this conclusion and finds that moving all Medicare Part D prescriptions to a 7-day fill would result in increased costs to Part D payers of over $800 million annually. Even moving more expensive brand products to a 7-day fill would still increase costs to Part D payers of $154 million annually.
"While LTCPA supports the goal of reducing waste, we also recognize the need to consider all costs associated with the proposed rule, so that unintended consequences do not result from the application of the rule. Given that it's the American taxpayer ultimately shouldering the burden of paying for this statute, it is critical that calculations such as those provided in our study be factored into the drafting of regulations," stated Bill Daniel, Executive Director for LTCPA.
The study derived its analysis from information received from eight LTC pharmacies. The findings estimated the amount of unconsumed medication among Medicare Part D residents in skilled nursing facilities and the potential cost reductions that could be achieved through shorter fill times.
In addition to the increased cost to payers, other key findings included:
* "Wasteful dispensing" to nursing home residents covered by Medicare Part D, only amounts to approximately 2.9% of total dispensed value. Short cycling this percentage of waste would save only $125 million annually and cost over $900 million in additional dispensing fees. This is in stark contrast to the $712.5 million in annual savings estimated by the Congressional Budget Office in their scoring of the short-cycling provision.
* The tradeoff between reduced waste associated with unused medication and increased pharmacy operating costs due to more frequent medication dispensing only becomes favorable to the taxpayer for prescriptions with original dispensed value of over $400.
In its comments, LTCPA stated that CMS's approach on short-cycle dispensing is contrary to Congress' intent that Section 3310 of the Patient Protection and Affordable Care Act result in savings to Medicare Part D. "We believe that it was Congress' intent to decrease costs associated with unused medications for Part D residents in LTC facilities. Implementing short cycle dispensing for long term care patients with an average length of stay of 835 days who are primarily taking maintenance medications does not meet this financial goal. While we applaud CMS's initial proposal to short cycle traditionally more expensive brand products, we believe that this limitation isn't narrow enough. Our data clearly shows that there is a prescription value threshold of $400 that must be met in order to achieve any cost savings," continued Bill Daniel.
In the proposed regulations, CMS calls for data collection by Part D plans in order to study the efficiencies of various dispensing methodologies and to estimate the cost of unused drugs and possible savings. As CMS has identified their lack of data on unused Part D drugs in this population, LTCPA recommends that before drafting any final regulations CMS conduct a study to determine the causes, frequency and cost of unused medications and also consider alternatives to 7-day dispensing cycles.
-----
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Wednesday, August 04, 2010
Medical Tourism Association Releases Healthcare Reform White Paper
(PR.com)-- The Medical Tourism Association has released an educational White Paper on Healthcare Reform, detailing what positive and negative effects healthcare reform is expected to have on both inbound, outbound and domestic medical tourism. Healthcare Reform passed into law in March 2010 and has both immediate implications and those to go into full effect in 2014. Many expect the reform will continue to raise healthcare and health insurance costs in the United States. As healthcare costs and health insurance costs rise in the United States this will push American patients to choose to travel domestically for medical tourism, a new term coined towards the provision of more affordable healthcare services within the US, or to leave the United States to travel abroad for medical care.
As stated by Devon Herrick of National Center for Policy Analysis, USA, “The recent Health Reform legislation contains virtually nothing to encourage patients and providers to control costs. By contrast, medical tourism represents global competition in health care, where providers compete on price and quality. Medical tourism is our best opportunity to encourage competition within the health care industry.”
The Healthcare Reform white paper is meant to give guidance and understanding on how the different aspects of healthcare reform will interact with medical tourism. The Medical Tourism White Paper can be read in the Healthcare Reform Updates section of the Medical Tourism Congress website. http://medicaltourismcongress.com/en/healthcare-reform-updates.html
“We have released this white paper in order to provide insight into healthcare reform and its different provisions, projecting how it may affect medical tourism. Many people around the world do not understand the lengthy healthcare reform document passed in the US and mistakenly think that it provides more affordable healthcare to Americans and that it will lower healthcare costs. Costs will likely go up under healthcare reform and this was reaffirmed in the recent medical tourism survey the MTA conducted with almost 100 insurance companies and employers, where almost 100% of respondents found that they believe costs will rise,” said Jonathan Edelheit, CEO of the Medical Tourism Association.
The healthcare reform and medical tourism white paper will be available at the MTA’s annual conference, The World Medical Tourism & Global Healthcare Congress, which will have a large focus on Healthcare Reform this year in Los Angeles, California from September 22-24th. The conference will focus on how healthcare reform affects employers, insurers, insurance agents, healthcare providers and patients and will peel back the onion of the thousands of pages of healthcare reform bill to look at how different aspects of health care reform will really work. www.medicaltourismcongress.com
The Medical Tourism Association also conducted a survey of over one hundred US insurance companies and US employers on the effect medical tourism will have upon them. The survey, “Healthcare Reform Survey Among Industry Stakeholders Discovers Similar Concerns,” July, 2010, shows a sample of the future growth potential of the medical tourism industry. 71 percent of insurance companies and employers felt healthcare reform was extremely positive for the medical tourism industry and more Americans would travel overseas under the new law. Employers and insurance companies know that healthcare reform will increase costs and medical tourism is one of the few ways to lower those costs. http://medicaltourismmag.com/article/healthcare-reform-survey.html
The Medical Tourism Association (Medical Travel Association), also known as the Global Healthcare Association, at http://www.MedicalTourismAssociation.com is the first international non-profit association comprised of the top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment. Our Association promotes the interests of its healthcare provider and medical tourism facilitators members. The Medical Tourism Association has three mission-driven tenets: Education, Communication and Transparency.
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As stated by Devon Herrick of National Center for Policy Analysis, USA, “The recent Health Reform legislation contains virtually nothing to encourage patients and providers to control costs. By contrast, medical tourism represents global competition in health care, where providers compete on price and quality. Medical tourism is our best opportunity to encourage competition within the health care industry.”
The Healthcare Reform white paper is meant to give guidance and understanding on how the different aspects of healthcare reform will interact with medical tourism. The Medical Tourism White Paper can be read in the Healthcare Reform Updates section of the Medical Tourism Congress website. http://medicaltourismcongress.com/en/healthcare-reform-updates.html
“We have released this white paper in order to provide insight into healthcare reform and its different provisions, projecting how it may affect medical tourism. Many people around the world do not understand the lengthy healthcare reform document passed in the US and mistakenly think that it provides more affordable healthcare to Americans and that it will lower healthcare costs. Costs will likely go up under healthcare reform and this was reaffirmed in the recent medical tourism survey the MTA conducted with almost 100 insurance companies and employers, where almost 100% of respondents found that they believe costs will rise,” said Jonathan Edelheit, CEO of the Medical Tourism Association.
The healthcare reform and medical tourism white paper will be available at the MTA’s annual conference, The World Medical Tourism & Global Healthcare Congress, which will have a large focus on Healthcare Reform this year in Los Angeles, California from September 22-24th. The conference will focus on how healthcare reform affects employers, insurers, insurance agents, healthcare providers and patients and will peel back the onion of the thousands of pages of healthcare reform bill to look at how different aspects of health care reform will really work. www.medicaltourismcongress.com
The Medical Tourism Association also conducted a survey of over one hundred US insurance companies and US employers on the effect medical tourism will have upon them. The survey, “Healthcare Reform Survey Among Industry Stakeholders Discovers Similar Concerns,” July, 2010, shows a sample of the future growth potential of the medical tourism industry. 71 percent of insurance companies and employers felt healthcare reform was extremely positive for the medical tourism industry and more Americans would travel overseas under the new law. Employers and insurance companies know that healthcare reform will increase costs and medical tourism is one of the few ways to lower those costs. http://medicaltourismmag.com/article/healthcare-reform-survey.html
The Medical Tourism Association (Medical Travel Association), also known as the Global Healthcare Association, at http://www.MedicalTourismAssociation.com is the first international non-profit association comprised of the top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment. Our Association promotes the interests of its healthcare provider and medical tourism facilitators members. The Medical Tourism Association has three mission-driven tenets: Education, Communication and Transparency.
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