The Florida Health Care Association said the removing skilled nursing centers from managed care would save taxpayers $68 million a year, a far cry from the $200 million cost claimed by the Agency for Health Care Administration.
The carve-out is contained in SB 682, a bill by Republican Sen. Kelli Stargel
FHCA Director of Reimbursement Tom Parker told the Senate Health and Human Services Appropriations Subcommittee Wednesday that AHCA’s numbers were based on some incorrect assumptions.
Mainly, Parker pointed out, the AHCA numbers are based on what it would cost if people who received home- and community-based services during certain times had instead been cared for in a nursing center.
“But that’s not how the system works, and it’s not what this bill does,” Parker said. “Rather, this bill focuses solely on exempting long-stay nursing center residents. There are no savings to be realized for these individuals, because their health and medical needs can only be addressed in a nursing center. They cannot be safely cared for in a home or a community setting.”
Parker said the state’s managed care system doesn’t work well for individuals who have to stay in the care of nursing centers long term, and that the system is costing taxpayers approximately $68.2 million in unnecessary fees each year by charging for management services that are not needed.
Though managed care doesn’t work well for long-term stays, Parker said, it is effective at making sure only those who truly need nursing home care are admitted to skilled nursing centers.
“For those individuals, we believe that the state and the nursing home can save money if they returned to a straight fee for service,” Parker said. “Florida has a long-standing commitment to help elders stay in their homes or community settings for as long as possible. But we must also recognize that for more and more of the frailest residents, a nursing home is the best – and perhaps only – realistic option.”