Medicaid is giving Virginia about $63 million less and Maryland almost $50 million less for nursing home care than the states are spending to provide it, according to a recent study by the American Health Care Association.

The report compared the actual cost of nursing home care in each state with how much Medicaid pays per patient. In Virginia, it cost $9.65 per day more to care for a patient than the amount Medicaid provides, resulting in a projected shortfall of $62.6 million for the states’ 2007 fiscal year, which ended June 30. In Maryland, the shortfall totaled $49.8 million, and D.C. received $14 million less than needed.

Virginia spent a projected $895.8 million total; Maryland spent $1.1 billion and D.C. spent about $150.7 million. None of the area jurisdictions was in the top 10 in terms of disparity; Illinois had the greatest shortfall, at $526 million

Nationally, the shortfalls totaled $4.4 billion, though that was an improvement over the $4.6 billion shortage two years earlier.

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The problems with Medicaid, the federal health insurance program for the poor, ultimately end up having an impact on Medicare, the insurer for the elderly, which is forced to prop up the other program, American Health Care Association President Bruce Yarwood said.

“The chronic underfunding of Medicaid undermines the financial integrity of Medicare to the detriment of our profession’s ongoing quality improvement efforts,” said Yarwood, whose group represents all assisted-care facilities.

Some states are taking action to combat the shortfall. Maryland lawmakers have proposed a tax on larger nursing homes with more than 45 beds. The funds generated by the tax, which would be no more than 2 percent, would be used to leverage additional federal funding to improve Medicaid reimbursements. About 32 other states have similar programs.

“That would generate more revenue,” said Mark Leeds, the Maryland Health Department’s director of long-term care, who noted the measure would require approval from the federal Centers for Medicare and Medicaid Services, and would not go into effect until the 2009 fiscal year.

Calls to Virginia and D.C. health departments were not returned.

melissa.frederick@dcexaminer.com