Dave Fulcher on the State of Wisconsin Medicaid Crisis

May 31, 2016 | Leadership

David Fulcher

Dave Fulcher, CEO

Recently, a new national report was published comparing state-by-state costs incurred by long term care providers with the Medicaid reimbursement those facilities received.  The report drew my attention because, according to the report, Wisconsin has the worst Medicaid reimbursement system for skilled nursing facilities in the nation.

What exactly does this mean?

The Report on Shortfalls in Medicaid Funding for Nursing Center Care is an annual analysis, which includes Wisconsin-specific data analyzed and contributed by the Wisconsin Health Care Association (WHCA). The national report confirms similar analyses of Wisconsin’s Medicaid reimbursement system for skilled nursing facilities conducted by LeadingAge Wisconsin, which found that Wisconsin skilled nursing facilities experienced a $331.8 million “Medicaid deficit” in 2014-15. The Medicaid deficit is the difference between the costs facilities incurred caring for their Medicaid residents and the state/federal Medicaid reimbursement they received for providing that care.

This means that Wisconsin skilled nursing facilities, which provide round-the-clock, year-round care for our state’s most frail elderly and disabled citizens, lost $55.89 each day for each of the estimated 16,490 Medicaid residents served in 2014-15, a 7.25% increase from the previous year. On an annual basis, that translates into an average facility loss of more than $1.1 million, a 2.52% increase.

Milwaukee Catholic Home is no exception to this disturbing trend. For a mission-driven organization like us, compromising quality of care is never an option. This means engaging in a constant effort to fill the gap between the exceptional care we offer and the inadequate funding provided to our residents through Medicaid. We are grateful to the generous donors who provide us with support in filling this gap. However, the problem remains significant, and we plan to be part of the conversation on a local and state level as we look at ways that we as a community can better provide for our most vulnerable members.  If you share our concerns, please contact your local legislator and let them know that failure to adequately support the care of our cherished seniors is not a sustainable practice.  We can work together to change the system for the better!

Report on Shortfalls in Medicaid Funding for Nursing Center Care, AHCA
Wisconsin Nursing Home Medicaid Losses and Fact Sheet, LeadingAge Wisconsin
The Wisconsin Health Care Association
LeadingAge Wisconsin