Like clockwork, MedPAC is back with their favorite hobby - recommending Medicare rate cuts for SNFs. This year's magic number: 4% for FY 2027.
Their logic? Medicare margins for freestanding SNFs hit 24.4% in 2024, and they're projecting 25% for 2026. In MedPAC's world, that means you're making too much money and they need to fix that.
The Denominator Problem: Sure, margins look great when 1% of facilities close every year and the survivors are the ones who actually know what they're doing. The buildings that were dragging down the averages are gone.
Congratulations to MedPAC for discovering that when weak operators exit, the numbers look better.
The Medicare Illusion: That $20,970 average payment per stay sounds nice until you remember Medicare is maybe 15% of your census. Your Medicaid rates are still underwater in half the states, and Medicare Advantage is denying everything that moves.
The "No Barriers to Care" Fantasy: MedPAC says beneficiaries won't have trouble accessing care if rates get cut. Tell that to the rural hospitals trying to discharge patients to SNFs that don't exist anymore.