With Medicare Advantage Rising and Resident Pool Shrinking, Nursing Homes Must Tackle Future Head-On

The COVID-19 pandemic paused most post-acute providers’ long-term planning efforts beyond making it through the next week or month, but now that the peak of the crisis has passed, it’s high time both operators and policymakers confront the new world ahead. That world will almost certainly bring a smaller crop of potential residents of skilled […]

Mitchell Family Office Acquires Nursing Home Operator, I-SNP Insurer American Health Partners

American Health Partners, which operates 29 skilled nursing and senior living facilities among other post-acute ventures, on Wednesday announced its acquisition by the Mitchell Family Office (MFO). The Birmingham, Mich.-based MFO explicitly pointed to the diversity of American Health Partners’ holdings as a reason behind inking the deal. In addition to its brick-and-mortar senior health […]

Ensign Group Acquires Three More Nursing Homes; Genevive, Medica Expand I-SNP to 140 Buildings

Skilled nursing giant The Ensign Group (Nasdaq: ENSG) on Tuesday announced the acquisition of three new skilled nursing facilities in Colorado. The San Juan Capistrano, Calif.-based Ensign picked up the following three facilities as of April 1: The 140-bed Boulder Canyon Health and Rehabilitation in Boulder The 76-bed Berthoud Care and Rehabilitation in Berthoud The […]

Home Health Giants Find Partners in Speeding Skilled Nursing Diversions Amid COVID ‘Fear Factor’

Home health operators aren’t the only players in post-acute and long-term care looking to capitalize on a weakened skilled nursing sector: As health systems and managed care insurers look to adapt their offerings to the post-COVID tastes of their patients, home health providers may find themselves with significant regulatory and payment tailwinds as they work […]

As Post-Acute Care Shifts Home, I-SNPs See Case for Expansion to Meet Growing Long-Term Share

The COVID-19 pandemic brought an unrelenting spotlight to clinical care in skilled nursing facilities — one that will shine in the form of government audits and investigations before the immediate crisis ends and long after it passes. But several operators had trained their sights on clinical care within their facilities before the start of the […]

Medicare Advantage Beneficiaries Log Almost 30% Fewer SNF Days Than Traditional Medicare

A new report comparing health outcomes for beneficiaries of Medicare Advantage (MA) and those on traditional fee-for-service Medicare put hard numbers to the differences in skilled nursing facility stays between the two groups. The findings show that MA beneficiaries spend far fewer days in SNFs than those covered by traditional Medicare. Specifically, SNF stays were […]

LTC-Led I-SNPs Continue to Launch for Now — But 2022 Will Be Year to Watch

When conferences were a staple of business development and not potential sources of contagion from COVID-19, skilled nursing providers would frequently pack the rooms featuring sessions on institutional special needs plans (I-SNPs). Under this model, SNFs can move into the Medicare Advantage world by offering their own insurance plans to beneficiaries who are living in […]

New Wave of ‘One-Sided’ Managed Care Contracts Could Lead to Payment Strains for Nursing Homes

Some aspects of the nursing home world do not change even during a global pandemic, and that includes the need to manage relationships with multiple payers. Several managed care organizations (MCOs) are now sending in their new contracts to skilled nursing providers as old agreements expire, Chad Bogar, the founder and CEO of the law […]

Provider-Led I-SNPs Grow 28% in 2021, Outpacing Traditional Medicare Advantage Insurers

Providers of nursing home care and other long-term services continued to expand their Medicare Advantage offerings into the 2021 plan year, as more operators look to gain financial control in a landscape where managed care maintains its steady march toward a Medicare majority. The number of provider-led Institutional Special Needs Plans (I-SNPs) increased from 76 […]

Medicare Advantage Growth Outpaced Traditional Medicare, 60% to 5%, Over Six Years

Medicare Advantage (MA) has seen dramatic enrollment growth over the past six years, significantly outpacing traditional Medicare, according to a report commissioned by the Better Medicare Alliance released October 15. The report, prepared by the actuarial firm Milliman, examined the growth in enrollment in MA and the similarities and differences between enrollees in that program […]

Medicare Advantage’s Strength During COVID-19 to Drive Expansion into New Markets, 50% Adoption by ’24

While the skilled nursing landscape continues to struggle both operationally and financially during the COVID-19 pandemic, those same negative forces have only served to strengthen private health plans — putting Medicare Advantage in an even better position to continue its growth. Cratering census and sharp declines in elective surgeries, while fiscally devastating for nursing homes, […]

Fresh Off Private Equity Pickup, Wound Care Provider AMT Seeks Skilled Nursing Expansion

A leading wound care provider sees expansion opportunity in both skilled nursing and the home despite the ongoing strains of COVID-19, with a recent private equity investment to back it up. American Medical Technologies in late August announced its acquisition by private equity firm One Equity Partners and investment management company The Silverfern Group, capping […]

CMS Orders Medicare Advantage Plans, MACs to Cover COVID-19 Tests Under New Nursing Home Guidance

The Centers for Medicare & Medicaid Services (CMS) on Friday instructed Medicare Advantage plans and Medicare Administrative Contractors (MACs) to begin covering all COVID-19 tests required for nursing home residents under new testing guidelines. The move came after the Centers for Disease Control & Prevention (CDC) updated its guidance around nursing home testing strategies last […]

How Saber’s I-SNP Partnership with Optum Gave the Operator a Head Start on COVID-19

In the era before COVID-19, specialty in-house Medicare Advantage plans had emerged as one of the hottest topics in long-term care — control the payer source, the thinking went, and an operator could eliminate the financial uncertainty and pressure that comes when working with managed care plans. But with a global pandemic running rampant through […]