Medicaid reimbursements for Florida hospitals will remain the same for another year after lawmakers reached a belated compromise on the healthcare budget, House and Senate leaders announced Wednesday.
The agreement, which keeps additional payments for largely “safety net” hospitals with a higher Medicaid caseload and increases state money for nursing homes by $40 million, resolved the final points of contention that had kept the legislative session from ending on time.
Sen. Rob Bradley, R-Fleming Island, the chamber’s budget chief, said House and Senate leaders had compromised by taking up the House’s plan for hospitals and the Senate’s plan to increase state funds for nursing homes.
The Senate had proposed changing the current Medicaid funding model for hospitals by redistributing $265 million of $318 million currently going to additional payments for 28 hospitals to all hospitals in the state.
$58 million How much was at stake in the Medicaid decision for Jackson Memorial
“If the policy for hospitals is what’s important to somebody, then they got that. If getting more money for nursing homes is what’s important, we got that,” he said Wednesday afternoon. “That’s how we worked out healthcare.”
Rep. Carlos Trujillo, R-Miami, the House’s budget chair, said the chamber’s priority was protecting the hospitals that currently receive the additional payments.
“We’re not going to cut the safety nets,” he said. “We’re going to protect the most vulnerable institutions in our state that we feel we have a fiscal, fiduciary and moral duty towards.”
Bradley said the nursing home issue was more important to the Senate, given the state’s higher percentage of older people. The agreement increases state nursing home funding by $40 million, which in turn will draw down an additional $60 million in federal funding, he said. The change in funding also coincides with an expected change in nursing homes’ Medicaid payment system later this year.
The $100 million for nursing homes still falls short of the Senate’s original $130 million proposal, Bradley conceded. “We got almost all the money that we wanted. It ended up being a great deal for everybody.”
But the Senate ceded to the House on its hospital funding plan, which would have funneled the enhanced payments into the base reimbursement rates for all hospitals. Under the Senate plan, Miami’s Jackson Memorial Hospital stood to lose about $58 million and Broward Health could have lost about $17 million, according to an analysis by the Safety Net Hospital Alliance of Florida. Other hospitals, including HCA, a for-profit chain, could have seen its reimbursements rise by more than $40 million.
$17 million How much Broward Health had on the line in the Medicaid decision
Proponents of the Senate plan had said changing the reimbursement model would have more fairly compensated hospitals for the care they provide, and that many of the hospitals that currently receive the additional funds are also capable of drawing down federal funding that other hospitals cannot. But the Safety Net Alliance, which represents many of the hospitals that currently receive the additional payments, said any cuts were unsustainable.
“I think that down the road, we’re going to have a model that follows the patient,” Bradley said. “For now it was more important to the Senate to make sure that we deliver on our promise that [Senate President Joe Negron] made early on to help our vulnerable elderly that are in our nursing homes.”
House and Senate leaders called a budget meeting late Wednesday night, and said they planned to call another meeting on healthcare spending Thursday morning. Rules require that the budget go through a 72-hour “cooling-of period” after it is completed before lawmakers can vote to pass the budget.