A by-hospital breakdown of the fiscal impact of the Legislature’s budget plan is available at http://www.hanys.org. 

Shockingly, New York’s Medicaid emergency room (ER) reimbursement rate has been frozen in place since 1991 at just $95 per visit—a fraction of the actual cost incurred by hospitals.  HANYS estimates that ERs lose $230 million each year due to this outdated reimbursement rate.  Many ERs have been forced to close, and the rest have had to absorb the tremendous increases in health care costs that have occurred over the last 15 years.

“Right now, every time a New York hospital provides ER services to a Medicaid patient the hospital loses hundreds of dollars, and sometimes much more,” Mr. Sisto said. “And when you multiply that by the better part of a million Medicaid ER visits a year statewide, you understand what a huge and unsustainable hit this is to the ERs and hospitals in every community in New York.”

In addition, the state’s reimbursement methodology for nursing homes has not changed since the 1980s, creating tremendous shortfalls in funding that facilities need to stay open and provide quality care.  In conjunction with other factors, the effects of these outdated reimbursement rates have been staggering.  Since 2003, 16 hospitals and 28 nursing homes have closed their doors in communities throughout the state.

The Legislature’s budget makes the investments necessary to sustain quality health care services by updating the Medicaid ER rate to $150, thereby providing a critical infusion of funding ERs need to continue providing life-saving services to their communities. In addition, the Legislature’s plan provides a modern, more equitable nursing home reimbursement plan that will better ensure nursing homes remain available for New Yorkers in every corner of the state.