The Ohio Department of Medicaid (ODM) has published the finalized Skilled Nursing Facility (SNF) Medicaid rates for the period of January 1, 2025, through June 30, 2025. These rates, which determine reimbursement levels for providers across the state, saw an average statewide increase of $3.23 per Medicaid day, bringing the new statewide average rate to $275.09. Notably, some provider peer groups experienced higher increases than others, with Peer Group 1-L seeing the most significant rise at $7.94 per Medicaid day, while Peer Group 3-L had the lowest increase at just $0.65.
The recalculations for quality point values, based on CMS data, have also impacted provider reimbursement levels. For the January 1, 2025, rate setting, the twenty-fifth percentile cut-point remained at 28.5 points, and occupancy points were held steady from the July 1, 2024, assessment. Direct Care rates were adjusted to reflect updated Case Mix levels, with 321 SNF providers opting not to freeze their Case Mix. The Medicaid Case Mix statewide average increased slightly by 0.21% from the previous year.
To help providers navigate these changes and explore strategies for financial success, Plante Moran is offering a free webinar on the 2025 SNF Benchmarking Report, which will provide an in-depth analysis of key industry trends and offer actionable insights on unlocking transformational success in skilled nursing operations. In addition to the webinar, Plante Moran has made the 2025 SNF Benchmark Report available for download, providing detailed benchmarking strategies and financial guidance for providers. Those interested can register for the webinar and access the full report here.
For more details on the finalized Medicaid rates and their impact on providers, access the full ODM rate analysis here.