Despite providers' complaints that the 1997 budget law cut them more deeply than expected, the Congressional Budget Office recently released figures that show that skilled-nursing facilities aren't losing much more than the office's original estimates.
The numbers, requested by members of Congress but not released publicly, show that over the first five years of the new prospective payment system required by the budget law, skilled-nursing facilities can expect their Medicare payments to decline by $9.4 billion.
That's only $40 million more per year than the CBO originally estimated, according to the document obtained by MODERN HEALTHCARE.
The new numbers fly in the face of assertions by skilled-nursing facilities that the PPS is jeopardizing their long-term financial health.
Skilled-nursing officials marched to HCFA's Baltimore headquarters April 23 to air their gripes and fears at a town hall meeting (April 26, p. 8).
It is unclear how much the new figures will damage the industry's campaign for relief from the budget cuts.
Skilled-nursing facilities have won considerable sympathy from high-ranking lawmakers, including Senate Budget Committee Chairman Pete Domenici (R-N.M.) and Rep. William Thomas (R-Calif.), who chairs the House Ways and Means health subcommittee. Domenici's state is home to Sun Healthcare Group, a major long-term-care company.
Provider groups questioned the recent CBO estimates. Robert Greenwood, a spokesman for the American Association of Homes and Services for the Aging, said the recent CBO numbers reflected only Medicare payments for inpatient services and conflict with a previous CBO report.
The earlier report, which addressed inpatient and outpatient payments, said skilled-nursing facilities would experience Medicare cuts of $7 billion more than anticipated during the first five years of the PPS. The CBO appears to be backing off those numbers, Greenwood said.
"What we'd rather focus on, since no one really knows what the numbers will actually be, is the effect that the PPS is having on beneficiaries," Greenwood said.