Skilled nursing has seen its highest occupancy level since April 2020, increasing 94 basis points to end February at 76.7%. That’s according to NIC MAP Data Service, powered by NIC MAP Vision. Authors of the monthly report suggest the demand for skilled nursing properties is recovering despite challenges encountered by staffing shortages and the delta […]
Category: Medicare Advantage
In another attestation to the health care industry’s expanding interest in value-based care models, AllyAlign Health has teamed up with two other health care organizations to form Curana Health — with a goal of being in skilled nursing and senior living communities across the country. AllyAlign Health, Elite Patient Care and Provider Health Services are […]
The Department of Health and Human Services’ top watchdog arm has raised concerns over some Medicare Advantage plans that have denied certain services requested by patients, including those trying to get skilled nursing care. MA plans issue millions of denials each year and the HHS Office of the Inspector General (OIG) found widespread and persistent […]
Skilled nursing providers are looking for ways to get ahead as the long-term care industry increasingly moves toward a value-based payment world. Operators who have taken the leap to create their own in-house insurance plans are starting to see the move pay off in a big way, both on the clinical and financial side of […]
Skilled nursing admissions continue to stumble toward recovery “with no clear end in sight” as others along the care continuum – like home health – are starting to steady. That’s according to the 2021 post-acute industry trends report from Atlanta-based health analytics company Trella Health. The report spans topics including admissions and utilization data in […]
Nursing home operators have for so long relied on Medicare fee-for-service (FFS) to get reimbursed, that it might take a rewiring of workplace culture to better receive value-based insurance models. This is especially true after the beating such models took during the pandemic, Cheryl Phillips, president and CEO of the Special Needs Plan Alliance, said […]
The value-based purchasing program (VBP) available to skilled nursing facilities, while garnering the attention of the Biden administration in its sweeping reform initiatives, was already under the microscope with federal agencies. The Centers for Medicare & Medicaid Services (CMS) already has been authorized to apply nine measures to the program in adherence with the Consolidated […]
The Medicare Payment Advisory Commission (MedPAC)’s value incentive program (VIP) seeks to standardize the many value-based purchasing programs that are available to different care settings, including skilled nursing. In its most recent report on Medicare payment policy, MedPAC devoted a chapter to the design of a VIP for post-acute care (PAC) in order to highlight […]
Skilled nursing operators will have until April 22 to decide whether they want to apply to become a part of the Centers for Medicare & Medicaid Services’ new direct contracting model. The Realizing Equity, Access, and Community Health (REACH) Accountable Care Organization (ACO) Model was announced by CMS last week. And while SNF participation in […]
As the Centers for Medicare and Medicaid Services (CMS) continues to evaluate the “true” budget neutrality of the Patient-Driven Payment Model (PDPM), it’s clear COVID-19 has impacted usage of the new payment model. A report from professional services firm CliftonLarsonAllen (CLA) found the median Medicare revenue per patient day (RPPD) increased 7% in 2020 under […]
With more long-term care provider organizations embracing Medicare Advantage institutional special needs plans (I-SNPs), the time might be right for skilled nursing operators to explore the potential benefits of expanding D-SNPs, or dual-eligible special needs plans. Special needs plans provide services to “special needs individuals” such as institutionalized individuals and people with severe or disabling […]
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) […]
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 […]
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