How Medicaid Helps Power High-Quality Care as We Age

Across the nation, millions of people who need long-term care to support their health rely on Medicaid. In fact, over 30% of Medicaid’s nearly $598 billion in spending in 2020 was on long-term care services.

Long-term chronic care, which offers a higher level of medical support than traditional skilled nursing facility settings, is no exception to this reality. At Hebrew Rehabilitation Center, Hebrew SeniorLife’s long-term chronic care hospital, we serve over 700 older adults each year who rely on Medicaid for their care. That number grows when you include all of Hebrew SeniorLife’s services. Patients at Hebrew Rehabilitation Center often have complex chronic diseases that require our unique long-term chronic care setting.  

In this blog post, I’ll explain Medicaid’s critical role in long-term chronic care, what reduced funding could mean for those who rely on it, and how Hebrew SeniorLife is adapting to protect high-quality care amid ongoing uncertainty. 

What is Medicaid, and who does it serve? 

Medicaid is a joint federal and state program that helps cover medical costs for those with limited income and resources. The federal government has rules that all Medicaid programs must follow, but each state runs its own program. That means eligibility and benefits may differ from state to state. However, all programs are required to cover income-qualified children, their parents, people who are pregnant, older adults, and people with disabilities.

In comparison, Medicare is federal health insurance for those 65 and older and some people under 65 with specific disabilities and conditions. In this blog post, I’m talking about Medicaid rather than Medicare because Medicaid offers benefits not typically covered by Medicare, including long-term care services.  

In Massachusetts, the name for the state’s Medicaid program is MassHealth. That means if you’re on MassHealth insurance, you’re on Medicaid!

You can find more information on the Mass.gov website if you’re uncertain about your eligibility for MassHealth. The admissions team at Hebrew Rehabilitation Center is also happy to help prospective patients determine their eligibility and submit applications to qualify for MassHealth. 

The role of Medicaid in long-term chronic care  

At Hebrew Rehabilitation Center, Medicaid plays a vital role in ensuring that older adults with complex health needs receive the high-quality care they deserve. Through MassHealth, providers like ours receive funding that helps sustain the services we offer and strengthen our capacity to serve all who need care.

The reimbursement we receive is determined through an agreement with the state. This approach helps ensure that essential services remain available and accessible. Because Medicaid is a partnership between state and federal governments, the funding we receive reflects a shared investment in public health and well-being.

Medicaid allows many long-term care patients to access the appropriate level of health care. That’s true for many people at Hebrew Rehabilitation Center, where around 75% are on MassHealth.

Because so many of our patients are on MassHealth, that funding is crucial for us to maintain our operations, and for people to remain in a care setting that is most appropriate to their needs. 

Long-term chronic care versus nursing homes 

If you’re unfamiliar with long-term chronic care or why someone might need that level of care over nursing home care or hospitalization, you aren’t alone! Another one of our blog posts offers a longer explanation of what long-term chronic care hospitalization offers.

Long-term chronic care provides patients with a higher level of medical care than they typically receive in other forms of long-term care, such as nursing homes. People with complex and chronic conditions receive 24/7 clinical oversight and therapeutic programs.

At Hebrew Rehabilitation Center, that means around-the-clock geriatric medical care, comprehensive therapy services, palliative care, life enhancement programming, and spiritual care. Patients can also receive on-site complex wound care, dialysis, chronic tracheostomy care, blood product transfusion, and intensive behavioral health services. Hebrew Rehabilitation Center has two bilingual floors for Russian speakers and three floors offering intensive memory support.

What’s at risk if Medicaid funding declines? 

Our collaborative relationship with Medicaid has helped us continue to deliver high-quality care to our patients. However, factors such as state and federal budgets and federal regulations can influence the Medicaid reimbursement rates we are able to receive.

If Medicaid reimbursement rates decrease, health care organizations may be forced to reduce services or delay necessary improvements, affecting care quality and limiting access for those who need it most. Additionally, because Medicaid is a joint program between the state and federal governments, cuts to the federal budget may affect reimbursement rates, even if the state budget remains the same.  

Ongoing Medicaid support isn’t just about dollars — it’s about ensuring older adults can receive the specialized care they need in the most appropriate settings. While Hebrew SeniorLife has a long-standing commitment to high-quality, dignified care, the reality is that declining funding jeopardizes the entire system’s ability to meet the needs of the older adult population.

Medicaid funding helps organizations like Hebrew SeniorLife deliver appropriate, high-quality care. The potential effects of reduced funding would go beyond any one organization or age demographic. Medicaid offers a financial safety net not just for people who need long-term chronic care, but also for others who need health care, including children, people with disabilities, and people who are pregnant.

How Hebrew SeniorLife is responding to uncertainty 

At Hebrew SeniorLife, our mission is to care for older adults with dignity and respect. That will not change, regardless of any potential funding uncertainties. 

We’re committed to ongoing process improvements and innovations that allow us to maintain high standards of care despite financial pressures — something we’ve practiced for years. Our resilience reflects our values, but we also recognize that sustainability requires systemic support. Even the most mission-driven organizations cannot do it alone. 

Our vision for aging is one of momentum and contribution, not decline. That’s why we’re calling on policymakers, community leaders, and all of us to ensure Medicaid remains a robust, reliable support for long-term chronic care. Together, we can protect the systems that support health, dignity, and quality of life as we age.

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