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Medicare Pays Well for Nursing Home Care: Senior Housing Group

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If nursing home owners had a choice, they might prefer to see Medicare patients come through the door.

Analysts at the National Investment Center for Seniors Housing & Care (NIC) have published data raising that possibility in a new summary of results from their monthly analyses of skilled nursing facility revenue trends.

(Related: 15 Cheapest States for Long-Term Care: 2017)

The analysis shows that patients who pay their own bills — using their savings, annuities, life insurance policy benefits, long-term care insurance and other personal and family resources — tend to pay only 19% more than patients getting help from Medicaid, and only about 60% as much as patients getting help from Medicare and managed Medicare plans.

Here’s who paid the residents’ bills in the first quarter, along with a comparison to the comparable figures in the NIC skilled nursing facility trends data for the first quarter of 2017:

  • Medicaid: 66% of the occupied beds, up from 65%.
  • Medicare and managed Medicare: 20%, down from 21%.
  • Private pay: 8.3%, down from 9.1%.

Here’s what happened to average revenue per day for the major types of payers:

  • Medicaid: $210, up from $200.
  • Medicare: $522, up from $508.
  • Managed Medicare: $431, up from $428.
  • Private pay: $260, up from $259.

NIC has posted copies of the latest skilled nursing facility trends report, and of earlier reports, here.

Some of the discrepancy between the average amounts of revenue per patient for different payer types may be due to the kinds of care required.

NIC does not try to adjust for the intensity of the care that residents require in the quarterly revenue trends reports.

Many patients getting Medicare benefits for skilled nursing facility care have entered a nursing home after being hospitalized for a stroke, a heart attack or another acute condition that may lead to a need for more expensive kinds of care.

— Read Maybe Traditional Medicare Should Cover Chronic Care, Too: Hearing Witnesseson ThinkAdvisor.

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