At What Cost: Medicare’s Cost- Saving Measures in Skilled Nursing Facilities and Their Impact on Vulnerable Populations

As the highest spender of health care in the world, the United States continues to look for ways to reduce its spending. As the main health insurance provider for the elderly and disabled, Medicare shares this mission. Unfortunately, some of Medicare’s cost-saving initiatives in one of its most critical care settings, Skilled Nursing Facilities, cause disproportionately negative impacts on vulnerable populations. This Note analyzes three of Medicare’s cost-saving measures in Skilled Nursing Facilities, namely value-based purchasing programs, the twenty-day limit on full coverage, and the practical matter provision. This Note highlights how these measures have a disparate negative effect on the most vulnerable populations, and then recommends solutions to mitigate these outcomes while still allowing overall cost savings for patients and the government.