Choices for Independence Gains Additional Funding

October 25, 2023

This article originally appeared on

Two agencies that keep 600 people out of nursing homes by providing in-home care have learned the state will give them a direly needed 42 percent Medicaid rate increase — more than they had asked for. 

“It’s a game changer,” said Keith Kuenning, Waypoint’s director of advocacy. “We’ve been working on this for years. This has been astounding.”

Waypoint and Ascentria Care Alliance warned the state this year that without significantly higher Medicaid payments, they’d have to end the care that allows people to manage their health needs in their homes. Doing so would leave their clients at a fork in the road: join nursing homes’ long waiting lists or try to persuade a family member to step in.

We’re teetering on the edge,” Amy Moore, director of in-home care at Ascentria, told the Bulletin in March. 

The Department of Health and Human Services has since responded with updates Ascentria and Waypoint did not expect. Jake Leon, DHHS spokesperson, said a few other organizations have received similar news regarding boosts to Medicaid reimbursement. 

Those include ambulance providers; the children’s dental program; and pregnancy care providers, including midwives, obstetricians, and birthing centers. The state has seen birthing centers that take Medicaid patients close or struggle because the reimbursement rates have not kept pace with increased costs, particularly for malpractice insurance. 

This year’s budget negotiations were dominated by dire warnings from health and service providers beyond just Waypoint and Ascentria about inadequate Medicaid reimbursement rates. Health care providers partnered to lobby lawmakers on rate increases. They called themselves the “Varsity Team.”

Lawmakers listened, so much so that when House budget writers were waiting for state revenue estimates, they put a hold on some expenditures such as higher education investments to protect money for Medicaid increases.

The state’s hospitals prioritized that investment too, telling lawmakers they would give up their Medicaid rate increase to benefit other providers like behavioral health centers and long-term care services that help keep people out of the hospital.

The state budget passed in June had an unprecedented $134 million for Medicaid rate hikes, an amount that comes to nearly $300 million with the federal match. It was far more than the $24 million Gov. Chris Sununu included in his budget proposal for increases.

All providers saw a 3 percent increase in Medicaid payments in July, the start of the budget year. They’ll see additional raises come January. 

Those increases will give the state’s 10 community mental health centers, which also pleaded for more support, $16.6 million plus the federal match. The majority of the 60,000 people the centers treated last fiscal year were insured by Medicaid. 

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