Increased Investment In Medicaid Needed To Protect Houston Area's Most Vulnerable Seniors, Disabled
November 08, 2017
In testimony
before a field hearing of the House Human Services Committee, the
President of the Texas Health Care Association (THCA) said that in order to
protect the Houston area's most vulnerable frail, elderly and disabled
seniors, it will be essential in the year ahead to initiate a much-needed
discussion about how to strengthen the Texas Medicaid program's
reimbursement rate, which has dangerously slipped to 49th in the entire
nation.
"Now more than ever, Mr. Chairman, we need to initiate a discussion
about how to strengthen our Medicaid program - especially in Texas, where
our Medicaid reimbursement rates have slipped to 49th in the entire nation,
and which simply does not reflect the challenges faced daily by our state's
most vulnerable seniors and the providers who care for them," testified Tim
Graves, President of the THCA in Austin. "With Medicaid financing a joint
state-federal responsibility, we will be strongly urging our Austin and
Washington-based lawmakers to take a hard look at the fact that while the
average national daily Medicaid rate per patient is $153.83, the Texas rate
is just $106.59, according to independent data from the national accounting
firm BDO Seidman, and other sources."
Graves said that even on a regional basis, Texas has fallen behind: New
Mexico ranks 30th nationally, at $137.24; Oklahoma ranks 44th, at $116.84;
Arkansas ranks 47th, at $111.76; and Louisiana ranks 45th, at $115.00.
Besides the fact that the Texas Medicaid rate requires modification to
reflect the realities of the health care marketplace, he said, we must also
assess how the pending demographic tidal wave of retirees, a great many of
whom will ultimately require long term care and services, will place
further stress on an already over-burdened Medicaid financing structure.
"No serious health care policy expert believes Medicaid can be sustained in
its current form, and with the current financing structure," Graves warned.
Compounding Texas' Medicaid funding crisis are proposed federal cuts to
Medicare and Medicaid contained in the Bush Administration's FY 2009
budget. "On top of Texas' already over-burdened state Medicaid program -
federal Medicare cuts will create an even more problematic scenario for
your most vulnerable elderly and disabled constituents," Graves told the
lawmakers. "With upwards of 60 percent of nursing home operating expenses
in Texas long term care facilities driven by labor costs, additional
financial pressures placed on them by federal funding cuts will undermine
patients' care, and further destabilize our direct care workforce."
To help protect and preserve access to high quality long term care
throughout Texas, particularly in our rural areas where facilities are
often the largest local employer, Graves said THCA is pleased that three
members of the U.S. House delegation - Lloyd Doggett, E.B. Johnson and
Solomon Ortiz - have signed a new congressional letter to House Budget
Chairman John Spratt (D-SC) and Ranking Member Paul Ryan (R-WI) asking them
to help stop the Medicare and Medicaid funding cuts proposed in the Bush
Administration's budget blueprint.
THCA is urging more members of the Texas U.S. House delegation to sign
this letter, which helps focus attention on the increasing interdependence
between Medicaid and Medicare. States the letter:
"Approximately 80% of nursing home patients rely on either Medicare or
Medicaid to pay for their long term care. Given that the fastest growing
segment of our population are those 85 and older, our nation's need for
long term care is likely to increase significantly. Providing adequate
reimbursement for long term care under both Medicare and Medicaid will
ensure that this growing population will continue to have access to long
term care.
"Despite the growing demand for long term care, the existing financing
mechanisms for Medicare and Medicaid are intertwined and increasingly
dysfunctional. Medicare and Medicaid funding comprise the vast majority of
all skilled nursing facility (SNF) payments. The Administration's proposed
reductions to Medicare payments to SNFs are especially egregious when the
drastic underfunding of Medicaid-financed SNF care is considered. For 2007,
SNFs received $4.4 billion less than needed to cover the costs of providing
care to Medicaid patients according to BDO Seidman. The Administration's FY
09 budget, however, ignores this perilous situation and calls for nearly
$24 billion in cuts to Medicare SNF funding over five years.
"Recently, the long term care sector has experienced relative economic
stability, allowing SNFs to enhance the quality of care and better meet the
needs of its patients. These patients are experiencing more medically
complex conditions than ever before and these unjustifiable cuts would
therefore jeopardize this already underfunded system and further
destabilize our nation's long term care infrastructure."
Stated Graves: "Mr. Chairman, I cannot emphasize more strongly that
care quality in our nursing homes - and continued progress in quality
improvement - is directly tied to funding stability in Washington and in
Austin. I am proud to say that here in Texas, we are indeed making strides
on the quality front, but those results are in jeopardy due the financial
environment in which we operate."
The THCA President said his organization will continue to
enthusiastically partner in government and profession-wide quality
improvement programs, and concluded by stating, "Government has every right
to insist upon quality care, but so too does government have an obligation
to finance that care - particularly in terms of paying the actual cost of
providing that care. We do not believe that is an unreasonable
expectation."
For complete text of Graves' testimony before the House Human Services
Committee, go to txhca.
Founded in 1950, the Texas Health Care Association (THCA) is the
largest long term care association in Texas. THCA represents a broad
spectrum of long term care providers and professionals offering long term,
rehabilitative and specialized health care services. Member facilities,
owned by both for-profit and non-profit entities, include nursing
facilities, specialized rehabilitation facilities, and assisted living
facilities.
Texas Health Care Association
txhca