Legislature must up state’s Medicaid reimbursement

I think most Nevadans would agree that we need to take especially good care of our most senior citizens, and that we haven’t always done a great job at delivering on that goal.

In addition to funding, one major challenge is demand. In Nevada and nationwide, demand continues to grow for what people in our profession call post-acute health care (which includes skilled nursing and related care facilities). It’s vital for everyone in Nevada to understand that we must keep pace with this demand. It’s also important to know what we’re doing about it.

The Nevada Health Care Association and the NVHCA Perry Foundation have already enacted changes that have improved the level of care and improved the state’s health care rankings. We’re working with state and industry leaders to make more improvements.

But we have a long way to go, and we can’t do this alone. Over the next month or so, we need the support of concerned citizens to join us in urging Nevada lawmakers to raise Medicaid reimbursement rates that haven’t increased in more than a decade. This is critical to improving quality measurements and the overall level of care in Nevada.

While our elected officials debate how to resolve the competing demands of education, economic development and more, Nevadans can’t afford to sit back and hope for the best. Increased reimbursement rates are vital to help our local facilities cover the rising costs of caring for seniors utilizing Medicaid. Nevada’s low reimbursement rates for providers who care for Medicaid patients affects the ability of NVHCA members to provide and improve care. So much so, our state pays for Nevadans to live in other states in order to receive adequate care.

A rate increase is necessary to modernize our health care delivery system and improve education. This increase must not be so high that it inhibits the state’s ability to attract new industry, and at the same time provide the required infrastructure health care and education needed for our state.

As we near the end of Nevada’s 120-day legislative session, our state’s budget for the next two years will come more clearly into focus. Unfortunately, current budget bills being debated in the Legislature will not be enough for much-needed improvements in education and health care, as reimbursement rates aren’t the only challenge we are facing.

A shortage of nurses and other clinicians, such as physical therapists, occupational therapists, behaviorists, psychologists, psychiatrists and others, also affect the quality of care in Nevada. We believe lawmakers should do all they can to fully fund the launch of the University of Nevada, Las Vegas School of Medicine to generate the volume of Nevada medical students we need just to keep up with our growing demand. This, in conjunction with adequate reimbursement rates, would create positive change.

Change is possible: Despite drawing from very limited data, a “Nursing Home Report Card” released this year by Families for Better Care indicates Nevada’s overall national ranking for providing quality care in skilled nursing facilities surged to 26th overall, up from 43rd in the U.S., making Nevada 2014’s most improved state. Nevada showed improvement in five of eight quality measures, and the state’s direct-care staffing hours increased an extra 10 minutes per resident every day.

Over the last two years, with help from NVHCA and the Perry Foundation, the accuracy rate of key performance measurements in skilled nursing — referred to as the “minimum data set” or MDS — has improved from 74 percent to as high as 82 percent. (MDS is part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid-certified nursing homes and provides a comprehensive assessment of each resident’s functional capabilities, helping nursing home staff identify health problems).

This improvement brings Nevada closer to the national average of 85 percent. Over the past year, thanks largely to the education and training efforts of the Perry Foundation, the federal government rankings of skilled nursing facilities in Nevada found the number of local facilities rated the highest in quality — those with four- or five-star rankings — increased by 23 percent. The number of one-star centers needing the most improvement fell by 32 percent.

Ultimately, sustainable and positive change will only come to post-acute health care in the state when substantive and positive change comes to Nevada’s Medicaid reimbursement rates. But we need your support and participation. I encourage you to visit the Nevada Legislature website (www.leg.state.nv.us) and get involved by following this issue and communicating with your legislators.

Daniel Mathis, a licensed nursing facility administrator, is president and CEO of the Nevada Health Care Association.