Tuesday, November 10, 2015

Medicaid and Long Term Care

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In the study “Examining Differences in Death Rates for Medicaid and Non-Medicaid Nursing Home
Residents,” Dr. Jennifer Troyer of University of North Carolina disclosed that the mortality rate of Medicaid patients is 14.8% higher than the mortality rate of private-paying residents. Although the high death rate can be caused by other factors, it could still be a sign that there is a difference in the level of care provided to the two groups of long term care patients. What could be the reason behind these possible differences?

1.     Medicaid has low payment rates. Nursing homes, in general, prefer private-paying residents because they can only charge so little with Medicaid patients. As a result, more often than not, the only nursing homes that accept Medicaid patients are those which do not attract enough private-paying patients to fill their beds. Rather than having empty beds, they decided to accept Medicaid patients instead.

2.     Lower staff to patient ratio. Nursing homes with high number of Medicaid patients are operating with lesser resources compared to nursing homes with high number of private paying patients. Consequently, they sometimes end up hiring less experienced staff or fewer staff than necessary. This, in turn, leads to overworked staff. And like in any other industry, overworked staff are associated with high incidents of negligence. In worse cases, even abuse.

3.     Long waiting list. Because of the great demand for long term care and limited number of available beds, the waiting list for Medicaid patients is longer than private paying patients. As a result, Medicaid patients often have to go wherever there is an unoccupied bed, notwithstanding the distance of the nursing home from his family, the quality of care it provides or its overall ambiance. Due to travel costs and travel time, family members are often forced to limit the number of times they visit their loved ones. This makes Medicaid patients more at risk of depression.


The above-mentioned observations simply mean one thing. While Medicaid can be a great help for people who have no other means to pay for care, people who can afford to have better financing options like long term care insurance should find one. That is, if they do not want to go through the same ordeal that most Medicaid patients have to bear with.

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