Ryan budget proposal calls for Medicare vouchers, Medicaid transformation

The House healthcare reform bill would offer a temporary Medicaid payment program that would provide $6 billion to certain nursing homes for four years. It also would trim the Medicare market basket.

The Nursing Facility Supplemental Payment Program would target those facilities with high Medicaid populations and that are dually certified in Medicare and Medicaid, noted Susan Feeney, spokeswoman with the American Health Care Association. The program “represents a first step in acknowledging the nation’s chronic Medicaid underfunding crisis,” Bruce Yarwood, president and CEO of AHCA, said in a statement.

While the bill would offer Medicaid funding to facilities, it also would cut Medicare funding to nursing homes. The Affordable Health Care for America Act (H.R. 3962) would eliminate the market basket (or cost-of-living update) for the final three quarters of fiscal 2010 and add a productivity adjustment — a net cut — to the market basket, Feeney said. These two actions would result in a reduction in Medicare of $23.9 billion over 10 years, according to AHCA.

The bill has several other provisions that would affect nursing homes and seniors. These include a measure to establish a Center for Medicare and Medicaid Innovation, which would “test and expand new payment models that encourage higher quality and lower cost.” It also has, to many people’s surprise, an end-of-life care provision. Opponents had dubbed this the “death panel” provision last summer. It would require health insurers participating in an insurance exchange to provide information on advance care planning.