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You can read the who-and-how in this New York Times article

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Multiply the applicable wage index determined under Steps 2 and 3 by the amount determined under Step 1 that represents the labor-related portion of the national unadjusted payment rate

But if you take support away from the hospitals and the nursing facilities, the balloon is going to be affected somewhere else in the Medicaid balloon. Provider taxes are a means for states to collect tax revenue from providers such as nursing home operators and, in turn, trigger a larger federal Medicaid contribution, enabling dollars to be redistributed to providers