Nearly a decade after the Centers for Medicare & Medicaid Services (CMS) established accountable care organizations (ACOs) in conjunction with the Affordable Care Act, the health care landscape has shifted even further toward a focus on outcomes and value. As recently as October CMS and the Centers for Medicare & Medicaid Services Innovation Center (CMMI) […]
Category: Medicare Advantage
After a seven-month streak in occupancy gains, skilled nursing facilities experienced a decline from August to September. Despite decreasing 27 basis points to 75% in September, overall occupancy is still 355 basis points above its low point in January at 71.5%, according to NIC MAP data, released by NIC MAP Vision. “There remains cautious optimism […]
As skilled nursing facilities work to build back hospital referrals lost during COVID, one way some are opening themselves up to new patients is by increasing their participation in managed care despite the tighter margins that come with it. With skilled nursing occupancy still below pre-pandemic levels, operators simply are no longer in a position […]
Former ProMedica Senior Care President David Parker took on a new role at Optum this summer, putting his 30-plus years in skilled nursing executive leadership to good use as vice president of strategy for its complex care management division. Optum is the care delivery arm of UnitedHealth Group, and has offered value-based care plans for […]
Despite slower than recent monthly gains, skilled nursing occupancy still increased in August for the seventh consecutive month, according to the most recent NIC MAP® Data, released by NIC MAP Vision. Property occupancy rose 14 basis points from July to August, sitting at 75.2% — that’s a 378 basis point gain from January, NIC MAP […]
Medicare Advantage delivers $32.5 billion, or $123.36 per member per month, in additional value to beneficiaries, according to a report released Thursday by the Better Medicare Alliance (BMA). Hospital and physician services are 24% less expensive per month: $709.66 for MA plans per month and $935.67 for Medicare FFS. These statistics exclude administrative expenses and […]
Medicare Advantage advocacy groups are concerned the Biden Administration’s Build Back Better reconciliation bill will, in expanding Medicare fee-for-service (FFS), disadvantage MA. Advocacy and research group Better Medicare Alliance (BMA) on Wednesday hosted Reps. Brett Guthrie (R-Ky.) and Terri Sewell (D-Al.) to discuss the legislation further, and implications for the Part C plan under Build […]
Longevity Health Plan, a leading independent provider of Medicare Advantage (MA) institutional special needs plans (I-SNP) in the skilled nursing industry, announced this week that it will be expanding its reach in Florida, Illinois and New Jersey. Longevity will now offer I-SNPs in 300 additional nursing homes comprising more than 33,000 beds for coverage effective […]
SCAN Health Plan’s new institutional special needs plan (I-SNP), coined “Embrace,” covers multiple parts of the care continuum: skilled nursing, home health and assisted living. A subsidiary of SCAN Group, the Long Beach, Calif.-based SCAN Health Plan announced its new model of care last week. “Embrace” will launch in Los Angeles and Orange counties in […]
With Medicare Advantage revenue “significantly lower” than fee-for-service reimbursement, a new Zimmet Healthcare Services Group analysis says, skilled nursing facilities need to weather today’s “reimbursement storm” in order to make it to the incoming wave of baby boomers that will need facility services. In the meantime, Zimmet suggests operators utilize facility data to improve MA […]
Of the two million patients admitted to nursing homes every year, an anticipated 35% could be diverted to home health care if the Choose Home Care Act of 2021 becomes law, according to Keith Myers, chairman and CEO of LHC Group. Myers, along with Visiting Nurse Health System CEO Dorothy Davis, spoke about the legislation […]
As Medicare Advantage enrollment continues to climb and operators look for a seat at the table, ProMedica Senior Care President Angela Brandt believes now is the time to recognize the role long-term care facilities can play in value-based payment. “We all have to get comfortable with where we add value for the health care continuum […]
The delta variant and staffing challenges have slowed occupancy gains over the summer, yet skilled nursing still saw an increase in occupancy for the sixth month in a row as of July. NIC MAP® Data, released by NIC MAP Vision, found occupancy increased 58 basis points from June to July to land at 75%. It’s […]
The Centers for Medicare and Medicaid Services (CMS) has made headway separating metrics changes in the past year-and-a-half, tying some to the pandemic and others to implementation of the Patient-Driven Payment Model (PDPM). John Kane, technical advisor and SNF payment team lead for CMS, helped the skilled nursing industry better understand the impacts of PDPM […]
Roughly 94% of Medicare beneficiaries want to receive post-acute care in the home rather than a skilled nursing facility, according to results of a Morning Consult poll released today. The poll was conducted on behalf of the Partnership for Quality Home Healthcare (PQHH), along with the National Association for Home Care & Hospice (NAHC). That’s […]
Value-based care management company AllyAlign Health last week announced it will offer two new co-branded Medicare Advantage plans to members of LeadingAge California, thanks to a partnership with the senior advocacy state group. The plans — institutional equivalent special needs plan (I-SNP) Align Thrive, and chronic conditions special needs plan (C-SNP) Align Connect — will […]
There’s a strong possibility that Medicare will move to mandate value-based payment models (VBP) for the nursing home industry in the years to come, according to industry executives. Dr. René Lerer and Brian Cloch, CEOs for Longevity Health Plan and Transitional Care Management, respectively, spoke at a panel on the future of VBP models during […]
Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure noted higher participation in value-based payment models like Institutional Special Needs Plans (I-SNPs) during a recent discussion with HealthAffairs, but also hinted that consolidation of such programs may be needed. “Too many models in too many places that aren’t coordinated with each other,” is how […]
Occupancy is still increasing month to month, but at a slower pace compared to earlier this year, according to a new data analysis from the data service affiliated with the National Investment Center for Seniors Housing & Care (NIC). From April to May the NIC MAP Vision report found occupancy rose 23 basis points to […]
As skilled nursing operators look for ways to build back hospital referrals, data shows that Medicare Advantage enrollment continues to climb, making some managed care experts wonder how smaller, traditional, single nursing home operators will be able to build a sustainable future. With Medicare Advantage enrollment now representing 46% of all 57.7 million eligible Medicare […]
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