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05/25/2016

ODM Finalizes Medicaid Prices

ODM Finalizes Medicaid Prices

Terry Moore from the Department of Medicaid (ODM) released final prices based upon updated inflation factors and a detail audit from Myers & Stuffer, LLP. The good news is all prices are higher than the originally projected prices released in December. If you use the SWA average Medicaid case mix of 2.6500, the increased prices average $1.53 per day. Below details the differences:

Final FY 17 Rebased SNF Prices

If you were able to remove (sell or give back) unused beds to drop to Peer Group 3, there still is a price advantage using the final prices but the differential did drop for Peer Groups 1 and 3:Peer Group

Terry Moore also released preliminary rates for 930 nursing facilities. The reason they are preliminary is the rates do not include the final quality adjustments. If we exclude 10 providers where rates do not look correct, rebasing for the entire industry has increased rates from a straight average of $177.31 per day to $191.79 per day.  Below is the average Medicaid rates per peer group compared to 1/1/2016 rates. While many individual rates may vary, only Peer Group 1-L appears to have a negative impact as a whole.

Avg FY 17 Rates Compared to 01012016 Rates

Leading Age Ohio will be sending you your individual rates within a week. If you have any questions, please email Nisha Hammel @ nhammel@leadingageohio.orgSpecial thanks to Chris Joos, Plante Moran for this analysis and information.

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