Analysis of Long-Term Care Payment Systems: Analyzing Nursing Home Capital Reimbursement Systems. Volume 3. Final Report

摘要

Volume 3 reports on analyses of alternative Medicaid payment methodologies for nursing home capital. The analyses used a simulation model, with information from the study states to compare and contrast the traditional and two fair rental capital payment ('fair rental net' and 'fair rental gross') approaches. The model enabled the comparison of alternative capital payment systems over time periods up to 30 years. The three financial outcome variables examined were cash flow, cost to the state, and rate of return to investors. The report concludes that the fair rental approaches offset the incentives of the traditional system for nursing home owners to frequently sell or refinance facilities. The results of the simulation model analyses suggested that these advantages could be obtained without greatly increased costs to the states over time, either for rate payments or for administration. The results applied to both of the fair rental approaches in comparison to the traditional approach. The differences between the two fair rental methodologies were minimal.