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Alliance for Quality Nursing Home Care Responds to Study in Health Affairs about Racial Disparities in Treatment at Nursing Homes

WASHINGTON, DC – In response to the report in the September/October issue of Health Affairs regarding racial disparities in treatment at nursing homes, Alan Rosenbloom, President of the Alliance for Quality Nursing Home Care ("the Alliance") issued the following statement:

"The report in Health Affairs, which highlights glaring racial disparities in the quality of nursing home care, should be distressing to all Americans.  There should not be two standards of care for anyone, but especially not for our seniors.  The disparities in the quality of care and treatment of African American seniors versus other seniors are wrong and unacceptable.  This should not be the case at any time, but most certainly not in 2007.

"The study notes that African Americans are more likely to receive care in nursing homes with a higher proportion of patients who are Medicaid beneficiaries.   Medicaid -- the joint federal/state program designed to provide health care coverage to low-income individuals -- pays on average roughly $14 per day less than the reasonable cost of care.  This difference in payment forces nursing homes to cross-subsidize care through treatment of Medicare beneficiaries or patients who pay privately for care.  According to the report, African Americans are concentrated in precisely this type of facility. 

“It is unfortunate, but not surprising, that nursing homes heavily dependent on Medicaid are less able to hire staff or satisfy other quality metrics.   In recent years, only the stability in Medicare payments has allowed America’s nursing homes to maintain and improve quality of care while still remaining financially viable.   As the authors conclude, improved Medicaid reimbursement is essential to correcting these racial disparities. 

“Given the importance of Medicare payments to sustain cross-subsidization of Medicaid losses, the report provides yet another illustration of why the recent U.S. House of Representatives’ proposal to cut $2.7 billion in Medicare funding for nursing homes would be disastrous if enacted into law.  Not only would these cuts exacerbate the disparities noted in the report, they also would undermine quality of care for all nursing homes and risk adverse consequences for the entire direct care work force, 30% of whom are minorities and 86% of whom are women. 

“Racial disparities in health care are unacceptable.  This report is an important first step in addressing the issue in nursing homes, and the nation would do well -- as the authors recommend -- to examine the obvious relationship between inadequate government payments and inferior quality outcomes." 

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The Alliance for Quality Nursing Home Care (www.aqnhc.org) is a coalition of 16 of the nation’s largest skilled nursing providers who deliver care to hundreds of thousands of patients on a daily basis.