HCA has issued our 2020 State of the Industry report. Consistent with past reports, we find that the vast majority of community-based providers and Managed Long Term Care (MLTC) plans are operating with negative or negligible margins.
Providers carry an average accounts receivable of 69 days outstanding. Also, about a quarter of direct caregivers leave home care organizations for a variety of reasons, with turnover rates as high as 63 percent, imposing major unreimbursed costs on organizations.
“The fiscal pressures facing New York’s Medicaid budget are rightfully an area of concern that HCA readily shares,” HCA concludes. “However, state policymakers should not overlook other correlative trends impacting home and community-based services,” noting new obligations and responsibilities like minimum wage changes and the expansion of MLTC benefits for which “state Medicaid funds … have fallen short while nevertheless adding to the state’s budget pressures.”
The report reiterates our call for productive cost-offsets optimizing Medicare and other forms of coverage, improved procedural efficiencies, and quantifiable cost-savings due to home care interventions.
Each of these recommendations “meet the Governor’s test for the [Medicaid Redesign Team]: zero impact on local governments, zero impact on beneficiaries, finding industry efficiencies, and supporting system integrity,” we write. “To this charge we add another: ‘assure the viability of providers meeting the needs of beneficiaries, programs and services.’”