Medicare/Medicaid Reimbursement Pitfalls of the Skilled Nursing Facility

Health Care

November 01, 2007
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The case mix indices were recently published for Wisconsin SNF Medicaid residents as were the new Medicare rates. Many facilities noted that their Medicaid rate dropped significantly from 2006 and their overall average Medicare rate per day either dropped or remained stagnant.

Wisconsin case mix indices range from 0.629 to 1.840. With the December 31, 2006, picture date, 187 facilities decreased, 4 facilities stayed neutral, and 205 facilities increased. However, due to the reallocating of funds and failure at the budgetary level, it is expected that as of the December 31, 2007, picture date, the July 1, 2008, rates will show significant decreases in Medicaid per day rates with some facilities forecasted to lose as much as $10 per day in Medicaid revenue.


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