In order to
better coordinate care for nursing home residents who are dually eligible for
Medicare and Medicaid, responsibility for long-term nursing facility services
should be shifted from Medicaid to Medicare, suggests a recently released
policy brief from policy research group Mathematica.
More than half
of all nursing facility residents are dual-eligibles, according to the policy
brief. It is projected that 42% of all nursing home funding will come from
Medicaid in 2010, while Medicare will provide only 20%. Roughly 35% will come
from private pay, according to the brief. Lead author James Verdier
acknowledges the large leap it would take to shift nursing facility funding
from Medicaid to Medicare, but he suggests a series of incremental moves that
could ease the transition.
Potential steps
that could lead to better coordination of care for dual-eligibles, according to
Verdier, include: shifting responsibility for prescription drug use in nursing
facilities to Medicare Part D plans that specialize in those services; provide
pay-for-performance incentives to nursing facilities to prevent avoidable
hospitalizations; ensure that Medicaid-funded home- and community-based
services coordinate with facility-based care after facility-based care becomes
Medicare's responsibility.
For more
information or a copy of the policy brief, visit the Mathematica Web site.