Joe Lubarsky, president Eljay LLC

Q: What has this year’s examination of state Medicaid rates shown?

A: Adequacy of Medicaid payment for nursing facility services continuing to decline to their lowest point since the inception of the study 11 years ago. 

Q: What’s that mean in numbers?

A: The deficit per resident day climbed to $22.34 on average in 2012. That’s a 20% increase in the shortfall over the last two years. It’s now projected to exceed $7 billion across the country. For every dollar spent on nursing care services, the state pays an average of 89 cents, or an 11-cent shortfall on every dollar spent.

Q: Is there any optimism ahead?

A: I don’t predict any significant shifts until there are significant improvements in state economies, and even then, the trend will continue to be toward a higher priority of funding for non-institutional services.

Q: What raised your eyebrows this year about this study?

A: It’s actually a little bit worse than what I expected. What concerns me the most is that, historically, states have never kept up with the costs, but at the same time, growth rates have never slowed at such a level as today. It’s just a 1% increase on average.