During a recent congressional hearing, lawmakers from both parties criticized Medicare Advantage plans for making it harder for seniors to get the nursing home care they need. The hearing, called "After the Hospital: Ensuring Access to Quality Post-Acute Care," focused on ways to improve long-term care options like nursing homes, home health care, and rehabilitation hospitals.
Concerns About Medicare Advantage and Nursing Home Care Plans
One of the biggest issues discussed was how Medicare Advantage plans often deny or delay care for seniors needing post-acute care. Many experts said these delays make it difficult for patients to transition smoothly from hospitals to nursing homes or rehabilitation facilities.
Paul Dongilli, the CEO of Madonna Rehabilitation Hospitals, shared an example of a 73-year-old patient who struggled to get the care he needed because of Medicare Advantage restrictions. He explained that almost half of the requests for nursing home and rehabilitation care are denied at first, forcing families to go through a long appeals process.
Impact of Nursing Home Closures
Lawmakers also discussed the rising number of nursing home closures, especially in rural areas. One reason for these closures is a lack of funding, particularly as the government considers cutting $880 billion from Medicaid over the next ten years. Many nursing homes rely on Medicaid funding, and experts warned that these cuts would force even more facilities to shut down.
For small nursing homes, especially in states like Alaska, Georgia, Louisiana, and West Virginia, these cuts could be devastating. If facilities close, seniors may have to travel long distances to find care or, worse, be left without any options at all.
Proposed Solutions
Lawmakers and healthcare leaders suggested several ways to fix the system:
Medicare Advantage Reforms – Ensuring that these plans follow fair rules for approving necessary care.
Medicaid Protection – Preventing deep cuts that would force nursing homes to close.
Better Care Coordination – Improving communication between hospitals, nursing homes, and home health providers.
Support for Healthcare Workers – Addressing the staffing shortages that make it difficult for facilities to provide high-quality care.
The Future of Post-Acute Care
Experts agree that changes are needed to ensure seniors get the care they need after leaving the hospital. Without action, more nursing homes will close, and access to care will continue to decline. Lawmakers are expected to introduce new legislation to address these issues in the coming months.
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