Low Medicaid Reimbursement Rates in Iowa

In Mason City, low reimbursement rates for several assisted living centers in Iowa is pushing people who are not in need of 24-hour care into care centers that are more expensive, said a state health care official to North Iowa caregivers, seniors and care center officials.

Executive director Steve Ackerson of the Iowa Health Care Association and Iowa Center for Assisted Living said to a group consisting of 45 area care center officials along with employees in Mason City that if nothing is done about cost containment, patients with low acuity shall go into nursing homes.

Ackerson tackled on various long-term care problems during a legislative forum at Good Shepherd Health Center. He went on to say that assisted living is a chief emphasis of his efforts in advocacy this year. He said the theme is care, and not cut.

Financially supporting home as well as community based amenities such as assisted living lets people stay there, he stated. It is less expensive for that state, and it is what people want as well.

However, in Iowa, Medicaid reimbursement is almost non-existed for residents in assisted living facilities.

Director of assisted living Jean Palmer at Good Shepherd Health Care Inc. pointed to statistics given by Ackerson that just 5% of the residents of Iowa’s assisted living facilities are on Medicaid. The rest are privately paying.

This is because of the low Medicaid reimbursement rate, said Palmer.

She said that in most nursing homes, the Department of Human Resources has to pay more in order to keep them there.

Director Mike Svejda of Good Shepherd Health Center Inc. stated that living in a nursing home was twice to thrice more expensive as opposed to assisted living.

Svejda went on to say that the state has to use the assisted living program more and this is through paying the assisted living program more in order for it to be more affordable for those people who have low earnings.

One way to do so is by putting in more money into the Home and Community Based Services waiver program in order to enable a lot more people to stay in assisted living, recommended Svejda.

In an associated issue, Palmer reported that those persons who are in assisted living who get benefits from the Veterans Administration are now obliged by the state to take away those benefits from the total that they get from the HCBS waiver.

Palmer stated that it acted as a disservice to the nation’s veterans.

Still another area that raised concern was the shortage of collaboration between the Department of Human Services and the Department of Inspections and Appeals in keeping an eye on the state’s long-term care facilities. Palmer said that they need to report to both bodies.

Ackerson stated that among the aims of his advocacy groups is to bring together DIA required reporting and DHS incident reporting so that assisted living facilities would be able to finish a single reporting process that would please the two bodies and decrease unneeded repetition of documentation efforts.

State Senator Amanda Ragan of D-Mason City stated that one of the key matters she got from Ackerson’s report is the fact that Iowa is performing a great job of working with a lot of seniors which is not an easy feat.

But according to Ragan, what is an alarming fact is the federal effect of the decrease in reimbursement for both Medicaid and Medicare, and that it is affecting the most vulnerable group of people, the elderly.

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One thought on “Low Medicaid Reimbursement Rates in Iowa

  1. Government in the U.S. today is often a senior partner in every business in the united states.
    Sooner or later, invariably winners are the ones who think they’re able to.

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