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Pennsylvania is Expanding Medicaid Coverage to Reduce Number of Nursing Home Enrollees

Pennsylvania Governor Tom Wolf’s administration is putting out a new Medicaid feature that’s aimed to decrease the number of enrollees in nursing homes in the future.  It is also intended to lessen a large expense for the state, which has a rapidly growing elderly population.  This plan has been in place in many other states for years and provides the road map for how it can be administered in Pennsylvania.

This new feature will have a financial incentive to get enrollees the medical care and services they need in their home instead of in the nursing home, where it can be twice as expensive.

The savings under this plan will be substantial. It is around $62,000 per year for nursing home care and about half that for the care at home.  There are over 50,000 Pennsylvania nursing home residents that are covered under Medicaid.

“Long term, you are expecting to see savings because you are going to be seeing more people getting services in a less expensive environment, which also happens to be where people want to get their services, at their home,” said Teresa Miller, Governor Wolf’s acting human services secretary.

The expected result of this will likely not be a mass exodus of current nursing home residents. However, the expectation is that it will allow individuals to stay in their home for a longer period when they have health issues that require more attention.  In the past those issues would have led them to move into a long term care facility to get the care they needed.

The program takes effect January 1st in 14 Pennsylvania counties.  There is also a plan to include Philadelphia and 4 bordering suburban counties in 2019 and for the remaining 48 counties in 2020.