Rhode Island Secures Rate Escalators for Medicaid Home Care Program

Home care providers in the state of Rhode Island have secured a much-needed Medicaid rate increase for the home care and hospice program.

The 2019 state budget includes a 10% unencumbered increase for Medicaid fee-for-service personal care attendant services and a 29% increase for Medicaid FFS skilled nursing, therapeutic care and hospice, both effective July 1, 2018.

In addition, the budget secured unencumbered annual inflation increases (COLA) for all Medicaid home care and hospice rates starting July 1, 2019. The plan is a first for a state Medicaid home care or hospice program in the nation, according to the Rhode Island Partnership for Home Care.


“By adopting an annual COLA, this will ensure that Medicaid-contracted home care and hospice providers will remain competitive in the labor market and meet the challenges of cost inflation for medical equipment and supplies, operational costs, workers’ compensation and professional liability insurance rates and federal and state taxes that have otherwise hindered providers from accepting Medicaid patients and have closed providersthat had a high Medicaid patient census ratio,” Nicholas Oliver, executive director of the Rhode Island Partnership for Home Care, said in a statement.

States frequently pass incremental increases to Medicaid programs to keep up with rising wage rates and inflation, though many home care agencies have to lobby for these actions themselves.

Personal care attendant services received small wage pass-throughs in 2008, 2017 and 2018 state fiscal years. However, skilled nursing, therapeutic care and hospice hadn’t received rate increases since 2002, according to the Rhode Island Partnership for Home Care.


“Hospitals and nursing homes have annual rate adjustments and fight to keep the COLA every year,” Oliver told HHCN. “Why can’t home care?  …  We saw the COLA as a vehicle to be able to not advocate for dramatic increases, but get us where we need to be.”

The new budget will ensure that home care providers don’t have to continue lobbying for new rate increases annually.

“I think our legislature is tired of hearing [they] need to remember us year after year, so they created a mechanism in Rhode Island in statute that allows us to have our rates adjusted  annually based on cost inflation,” Oliver said.

Written by Amy Baxter

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