Who primarily funds nursing home post-acute care?

• A. Medicare
• B. Private pay
• C. Medicaid
• D. Patients out-of-pocket

Answer: (C)

The main idea is the payer mix for nursing home post-acute care in the United States. Medicare does provide post-acute care after a qualifying hospital stay, typically for a limited period (up to about 100 days) and under specific conditions. However, the longer-term or ongoing care that many patients need after those initial post-acute days is funded primarily by Medicaid, especially for individuals with limited income or depleted resources who qualify for coverage. Because Medicaid covers a large share of long-term nursing home care and many post-acute stays transition into Medicaid-funded care, Medicaid ends up being the dominant payer in this space. Private pay or out-of-pocket payments are significant only for those who do not qualify for public programs or who choose not to use them.