Nicole Galloway, CPA

Controversial changes to a Missouri program that were aimed at keeping patients out of nursing homes have resulted in tens of millions of dollars less in savings than lawmakers had foreseen.

The state Legislature voted in 2017 to make eligibility for home care slightly harder to attain. The move was originally projected to reduce the number of beneficiaries and save the state about $43 million. But a new audit shows that the switch has saved only about $11 million, St. Louis Public Radio reported Tuesday.

The discrepancy, State Auditor Nicole Galloway (D) said, is because lawmakers did not consider that a typical beneficiary’s condition worsens in subsequent years. As Missouri’s population ages, the number of people needing such services will only increase.

“It seems like it’s something they could have had a handle on, in my opinion; All this historical data related to level of care scores shows they do increase,” Galloway told KCUR. “More realistic estimates would have helped avoid these problems.”

Before 2017, patients needed to have an eligibility score of 21 for state-funded homecare, but lawmakers voted to raise it about 15%, to 24, and cap how many units of services individuals could receive. Missouri’s Department of Health and Human Services is reportedly planning to change how it calculates these scores and is soliciting public comment through March.

While the homecare program is meant to keep beneficiaries away from costlier nursing home care, Missouri advocates last year railed against proposed reductions to such services. They argued that deep cuts could lead to an influx of patients needing to be moved to nursing homes, McKnight’s reported.