Implicit in the government’s decision to allow Medicare Advantage plans to cover telehealth services with federal dollars is a question: Just because insurance plans legally can do it, will they? At least in the early going, multiple providers of telehealth tech to skilled nursing operators have said yes — and the promise of plan savings […]
Category: Medicare Advantage
Big-picture thinkers in the skilled nursing space have increasingly talked about the need for operators to band together in the face of reimbursement pressures and new payment models — an urge that goes against the competitive nature of the health care industry, particularly in markets saturated with multiple post-acute options. But according to Plante Moran […]
The Centers for Medicare & Medicaid Services (CMS) on Friday finalized new guidance that will allow Medicare Advantage plans to expand coverage of telehealth services. Beginning in plan year 2020, Medicare Advantage providers can include telehealth services as part of their basic benefits to enrollees, moving remote doctor visits from an optional add-on to a […]
The Centers for Medicare & Medicaid Services (CMS) this week announced a 2.5% boost to overall Medicare Advantage payment rates — but the news isn’t likely to bring relief to skilled nursing operators struggling with low MA reimbursements. That 2.5% rate gain in 2020 represents a bigger gain than the 1.59% increase that the agency […]
On paper, the Patient-Driven Payment Model (PDPM) will only affect one pillar of the payment equation for skilled nursing facilities. But as players start to unpack the coming rule changes, PDPM’s reach begins to extend far beyond Medicare. Medicare Advantage and Medicaid frequently base rate calculations on the existing Medicare structure, a pair of experts […]
Skilled nursing operators saw static occupancy between the third and fourth quarters of 2018 — a notable, if moderate, bit of good news for an industry that had seen four straight years of declines. The nation’s nursing homes were approximately 82.4% full during the fourth quarter of last year, according to the most recent set […]
Large-scale efforts to shift post-acute residents from skilled nursing facilities to the home health space have largely “run their course,” Genesis HealthCare (NYSE: GEN) CEO George Hager said Tuesday, while also predicting serious cost savings under the new Medicare payment model. Though industry leaders have long worried about payers’ growing preference for the lower-cost home […]
Skilled nursing providers actually saw across-the-board gains in Medicare margins between 2016 and 2017, but the effects were mitigated by a familiar foe: Medicare Advantage plans. The average provider saw a profit of $102 per patient day for residents covered under Medicare Part A in 2017, according to a new analysis from accounting and advisory […]
Every industry gathering has a theme, whether it’s an intentional move by the organizers or not. But the most illustrative conference experiences come when attendees and those in charge both can’t stop talking about the same subject — as was the case this past week at the National Investment Center for Seniors Housing & Care’s […]
Skilled nursing facility operators frequently hear about how forging hospital partnerships is essential to their success under new payment models, but the intricacies of those interactions can often be difficult to navigate. Speaking at the National Investment Center for Seniors Housing & Care (NIC) spring conference in San Diego last week, the leader of one […]
Public-private partnerships will form the basis of comprehensive Medicare reform as the baby boom population ages, former Speaker of the House Paul Ryan predicted Thursday morning in remarks at a major skilled nursing and senior housing industry conference. “I believe the future for Medicare is in the Medicare Advantage type of space,” Ryan, a Wisconsin […]
It’s an existential problem that many providers face in the skilled nursing industry: New payment models demand substantial operational changes, but the current fee-for-service reality determines how they can pay and plan for those shifts. This frustrating dichotomy was on full display during a panel discussion on Institutional Special Needs Plans (I-SNPs) and other new […]
Medicare Advantage plans have emerged as one of the strongest pressures on skilled nursing occupancy and margins in recent years, and operators have scrambled to find any possible way to adapt. Many have found reason for optimism in calls to embrace data analytics as the key to survival: Prove your worth to Medicare Advantage plans […]
The federal government on Friday unveiled a series of new test benefits that certain Medicare Advantage plans can offer, including expanded telehealth coverage — marking yet another push toward remote health care benefits. The Centers for Medicare & Medicaid Services (CMS) will implement the programs under the Value-Based Insurance Design (VBID) model, which seeks to […]
As Medicare Advantage plans continue to pressure skilled nursing operators, one prominent leader in the space predicts that innovative providers can survive by leaning into the changes. By transforming their facilities into standalone medical-surgical facilities that can replace similar units in hospitals, SNFs can evolve into purely short-stay health care providers that thrive in the […]
It’s been a common refrain in the industry: To survive in a health care system increasingly moving to value-based payment models, skilled nursing facilities will have to form strong partnerships with hospitals, health systems, and accountable care organizations (ACOs). But doing that will be difficult if acute care facilities and ACOs aren’t interested in forging […]