Saltmarsh Siren: AHCA Publishes Medicaid Skilled Nursing Reimbursement Rates

9/14/2023 - By The Saltmarsh Healthcare Team

For all Skilled Nursing Providers in Florida who accept Medicaid: On September 5th the Agency for Healthcare Administration published the final Medicaid Nursing Home Reimbursement Rates for the rate-setting period beginning October 1, 2023. Providers are strongly encouraged to review these rates, which will take effect on October 1, 2023, and continue through September 30, 2024.  

The October 1, 2023, skilled nursing rates reflect numerous changes for the coming rate year, including, among others:

  • Updates to the Quality Measures component, including three new quality measures:
    • Percentage of Registered Nurse staff who left the facility over the past year
    • Percentage of long-stay residents receiving anti-anxiety or hypnotic medications
    • Number of hospitalizations per 1,000 long-stay resident days
  • Approximately $123mm in additional funding for the Quality Measures rate component
  • Base budget increase of one percent (1%)
  • Termination of hold-harmless provisions related to prospective payment system implementation in October 2018
  • Updated Fair-Rental Value and pass-through rate components

We anticipate that AHCA will publish the detailed rate sheets for each provider in the near future.  

Some providers will experience substantial shifts in their Medicaid reimbursement rates for October 1, 2023, due to these changes. If you have questions about the Medicaid reimbursement rate for your facility, please don’t hesitate to reach out to the Healthcare Consulting team at Saltmarsh. Our team of experienced professionals can help you understand your Medicaid rate and the components and inputs that are impacting reimbursement, particularly through the Quality Measures component.  

View current Medicaid rates on AHCA’s Nursing Home Rate page: ahca.myflorida.com/medicaid/cost-reimbursement/nursing-home-rates

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