This article describes the fiscal problems facing states when it comes to funding Medicaid nursing facilities. Cuts are to be expected in the future from many states while demand for services will continue to increase. The consequences of future cutbacks in Medicaid payment rates could result in reduced benefits, narrower eligibility and utilization restrictions among other cost-cutting measures. The authors of this article conducted surveys with state Medicaid reimbursement officials and examined reimbursement rates from 1997-2003. By tracking the reimbursement rates, the authors anticipate further rate decreases or rate freezes.

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