Medicaid: Methods for Setting Nursing Home Rates Should be Improved.
GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV
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As a result of the Omnibus Reconciliation Act of 1980, states are required to give assurances to HHS Health Care Financing Administration HCFA that their payment rates are reasonable and adequate to meet the costs incurred by efficiencly and economically operated nursing homes to provide care in conformity with applicable state and federal laws, regulations, and quality and safety standards. How effective have states been in establishing prospective payment systems that provide nursing homes an incentive to reduce costs without adversely affecting quality of care In our review, we identified weaknesses in each phase of the rate-setting process described above. These weaknesses meant that HCFA lacked adequate assurances that the states reimbursements rates were reasonable and adequate to meet the costs incurred by efficiently and economically operated nursing homes.
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