Delegates warned state Medicaid rate cuts and formula changes squeeze county nursing-home budgets
Summary
County officials explained state reimbursement calculations and recent adjustments that left counties sharing a larger nonfederal cost; speakers cited a local county contribution near $11 million and said a 3% shift in state policy reduced local revenues by about $330,000 this year.
A county official walked the delegation through how state Medicaid reimbursement is calculated and how a recent application of allowable-costs plus a statewide percentage reduction has affected county budgets. The official said the state first identifies allowable costs then applies a cut (noted in the meeting as about 28% in the current modeling), and explained that because the federal government matches state plan dollars the state's apparent cut does not translate dollar-for-dollar into savings for the state.
Delegates discussed local impacts: the county’s cited nonfederal share for nursing-home costs was described as about $11 million annually and the official said a recent change amounted to roughly a $330,000 reduction for Strafford County this year. Members recounted a prior episode of "double billing" that required legislation and an 18-month effort to recover funds, and they pressed staff to clarify ongoing budget assumptions when considering any capital plan for a new facility.
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