Nevada among lowest in cost of inmate healthcare

Nevada’s prison system spends less on inmate healthcare than all but two other states in the nation. What’s more, the cost of inmate healthcare in Nevada has fallen dramatically in recent years despite the relentless rise in medical and pharmaceutical costs.

The reason, according to prison officials, is Nevada has taken advantage of the changes in criteria within the Affordable Care Act and registered as many inmates as possible with Medicare or Medicaid, making the federal government pick up a large share of hospitalization costs — a major driver of total healthcare costs.

According to a study by the PEW Charitable Trusts released just last week, over the five years from 2010 to 2015, the study says Nevada’s spending per inmate fell by 21 percent from $4,126 to $3,246. Only Alabama and Louisiana spent less per inmate as of 2015. By comparison, in 2010, 11 states spent less on healthcare than Nevada.

As a result, the study says the inflation-adjusted annual cost of inmate healthcare fell $10 million over that time from $51.69 million to $41.27 million. The decrease began in 2014 when those changes in Medicaid eligibility took effect.

The study says, however, that doesn’t necessarily mean the state provides a lower level of medical treatment and healthcare.

While the inmate population has risen significantly in the past two years, the average daily inmate population during that five-year period only increased by a bit less than 200.

In addition, Nevada had 24.5 health care professionals on staff per 1,000 inmates, far fewer than the median of 40 staffers. That staff included 11 doctors, eight dentists and 145 nurses.

According to the report, Nevada’s prison population is aging. The percentage of inmates aged 55 and older increased from 9.6 percent in 2010 to 13.1 percent in 2015. That means more and more inmates in the state qualify for Medicare or Medicaid.

In addition, corrections officials say Nevada is one of just six states that operate a healthcare monitoring system to keep ahead of inmate medical problems and to monitor the quality of healthcare delivery, keeping data on medical care provided and outcomes.

The 2017 Legislature appropriated $2.3 million to corrections to purchase an electronic medical records system that should further improve healthcare in the state’s prison system.

States are required by a series of federal court decisions to provide “reasonably adequate” healthcare. But there’s a lot of flexibility in the definition of “reasonably adequate.”

As a result, the report says, “Health care spending per inmate varied dramatically” from $2,173 in Louisiana to $19,796 in California.”

The typical state department of corrections spent $5,720 per inmate. Five (Louisiana, Alabama, South Carolina, Nevada and Indiana) spent less than $3,500 per inmate. Four (California, New Mexico, Vermont and Wyoming) spent more than $10,000 per inmate.