Skilled Nursing News was able to sit down (virtually) with Amy Kaszak, president of special needs plans for Virginia-based AllyAlign Health, to talk about current trends in the skilled nursing industry.

Consolidation is on the horizon, Kaszak said, along with an increase in managed care, preventative services and home health supplemental options.

AllyAlign Health was established in 2013 and provides Medicare Advantage health plans to skilled nursing facilities, assisted living and senior housing operators, among other senior living providers. Ally operates in 22 states — 554 communities — with more than $350 million in premium undermanagement.

Please note that this interview has been edited for length and clarity.

What sorts of trends are you seeing, generally, in the skilled nursing market right now?

I think some of the really broad trends that you’ll see across the industry being reported is, one, there is a lot of market volatility, meaning that there are a lot of sellers, but there are also a lot of buyers. We’re certainly seeing some real consolidation.

Some of the well-established communities are not just selling one or two properties, but selling multiple or, you know, 20-plus properties. So a lot of buying and selling is going on. I think people are maybe evaluating, re-evaluating their strategy in light of COVID.

We are definitely seeing signs that many operators see this as an opportunity to expand their portfolio, to maybe double down on some of their strategies or even expand more into assisted living, home health … broaden their portfolio.

So, consolidation and diversification now and in the future?

I think short term, yes, definitely, as well as expansion of their base. If you’re skilled nursing, maybe you think about assisted living, or you look at that home health license that you’ve had on the shelf for a while that you haven’t fully used and you say, how am I going to diversify?

What about trends specific to Medicare Advantage?

More people are enrolling in Medicare Advantage. Estimates have gone up pretty dramatically, the percentage of total Medicare beneficiaries who are going to be enrolled in a Medicare Advantage plan. Medicare Advantage, overall, is expanding.

Original Medicare is moving at a faster pace than most people expected towards value based care. And, of course, the ultimate value based model is Medicare Advantage. Even with the change in (federal) administration, there’s no backing down from Medicare Advantage, and in fact, there’s potentially an even faster push to those value based models.

So it sounds like skilled nursing providers will see a shift to value based, managed care?

Skilled nursing home owners should be expecting that of their short stay (residents), for sure, but also their long stay residents, more of them will be in a managed care plan in the future. That’s because there are more plans, there’s expanded geographies for Medicare Advantage plans being offered.

And there is support from the current (Centers for Medicare & Medicaid Services) administration for Medicare Advantage. So yes, there will be more managed care in nursing homes, period.

Any skilled nursing trends that happen to be more long term?

Medicare and Medicaid are focusing more on preventative services, and Medicare is continuing to expand through Medicare Advantage, with supplemental benefit options that address social determinants of health, not just the traditional health related services.

I think that is going to impact skilled nursing, because it could mean that there are more options for patients. For post-acute care, as well as potentially for long term, skilled nursing.

There will always be a need for long term nursing home care. But there may be more options for some people to delay that, or do it differently through a mix of assisted living, home and community based services.

You’re going to start seeing a lot of movement in the home care space — that is, kind of a combo of licensed and home health. Plus, a lot of movement in outpatient therapy. Again, that’s part of this move toward expanded post-acute options.