Nursing home and Residential Care/ PNMI-C Rate Study is Underway

On Wednesday, February 1st the Department of Health and Human Services kicked off its rate study and rate reform work with a stakeholder meeting. MHCA was well represented on the call with our leadership team present. A new long term care payment model is anticipated for January 2025 and the Department noted a move from a cost settled methodology to a reimbursement system that is based fully or in part on prospective payments is anticipated. The Department and its contractor, Guidehouse, indicated that stakeholder input would be obtained through workgroups and/ or surveys and that additional information would be emailed out in the near future.

In addition to rate reform work and surveying what works in other states, the contractor will also be conducting a county by county long term care supports and services needs assessment. They will be looking at utilization, cost effectiveness, quality, etc. with the goal of identifying gaps in services. Stakeholder meetings will likely be scheduled every two months throughout the duration of this work and MHCA will communicate opportunities for involvement to the membership.

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