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Costs and Benefits of Enhancing Private Duty/Shift Nursing Payment Rates in Pennsylvania’s Medicaid Program

This report was enlisted by the Pennsylvania Homecare Association to evaluate the need for enhancing Pennsylvania’s Medicaid Private Duty Nursing (PDN) payment rates. Through a mixture of quantitative analyses and real-life patient examples, this report highlights the anticipated benefits this PDN rate increase is projected to yield. These benefits include increased staffing capacity, reduced hospitalizations, and improved family quality of life. The costs of the recommended PDN rate increase are estimated, as well as the offsetting saving from reduced hospitalization. This report ultimately aims to help address the challenges that many Pennsylvania stakeholders are currently experiencing for Medicaid-covered persons who are served in the inpatient setting when a transition home has been deemed clinically appropriate.

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