A recent Skilled Nursing News survey of nursing home operators found cautious optimism about the near-term future of the space, with a majority seeing a clear path to the future even without additional government support. At the same time, operators have largely been pouring that federal largesse — including CARES Act grants, Payroll Protection Program […]
Category: Medicare
The Patient-Driven Payment Model (PDPM), the overhaul to Medicare reimbursement for skilled nursing facilities that took effect in October of 2019, has proven its worth as a mechanism for paying for nursing care during a global pandemic. It has, however, been “anything but revenue-neutral,” at least in terms of how much money the government is […]
The federal government last week tapped a pair of retail pharmacy giants to distribute an eventual COVID-19 vaccine to nursing home residents across the country, and while there remain significant questions about the logistics of distributing an as-yet-unapproved vaccine, officials have continued to position the plan as the only workable solution to a massive public […]
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 […]
The federal government on Friday announced its intention to relax restrictions around billing Medicare for immunization in nursing homes, with the stated goal of speeding the eventual distribution of a COVID-19 vaccine. Skilled nursing facilities are typically required to bill Medicare directly for immunizations under the terms of the Social Security Act, even if the […]
Starting in January, the federal government will base Medicare payments for COVID-19 tests on labs’ ability to meet two-day turnaround times, docking them $25 per test for failure to reach the goal. Medicare will pay labs the current $100-apiece rate for high-throughput tests only if they can complete them within two calendar days of specimen […]
Even with limited data due to COVID-19, an annual benchmarking report found that the operating margin for skilled nursing facilities remained at zero for 2019. And given the costs of managing operations during the pandemic — to say nothing of the occupancy hit — the picture is bleak for margins in 2020. But for all […]
The nation’s top Medicare official this week expressed serious disappointment in the performance of alternative Medicare payment models, citing key design flaws and promising more mandatory programs to come. The Centers for Medicare & Medicaid Services (CMS) recently completed an analysis of several early attempts at value-based payment structures, with administrator Seema Verma disappointed in […]
LTC ACO, the accountable care organization (ACO) launched by Genesis HealthCare (NYSE: GEN), brought in $18.8 million for the nursing home operator under the Medicare Shared Savings Program (MSSP) during the 2019 program year. The ACO achieved sufficient Medicare fee-for-service savings among its 5,800 beneficiaries to trigger the payment, which translates to $17 million in […]
As skilled nursing operators gather themselves together to prepare for their new era in the wake of a pandemic that has upended their sector in particular and society more broadly, there are significant lessons to be learned from the COVID-19 era, according to the leader of the largest trade organization for nursing homes in the […]
The Centers for Medicare & Medicaid Services (CMS) confirmed the extension by more than two years of repayment terms for advance Medicare cash floated to providers, while also offering further relief of up to five years for operators in particular financial distress. Under the more generous terms, passed earlier this month as part of a […]
The federal authorities that regulate skilled nursing facilities issued a slew of changes to the rules governing nursing home care in the early months of spring as part of efforts to curb the spread of COVID-19 in the facilities. Some of those changes, such as the loosening of restrictions around the use of telemedicine, are […]
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, […]
The COVID-19 pandemic has reinforced the need for high-level clinicians in nursing facilities, but a pending change to Medicare reimbursements could force physicians to take a steep pay cut in order to continue to practicing in post-acute and long-term care — or push them further and further out of the space. The Medicare Physician Fee […]
After scoring significant successes in reducing hospital readmissions among its own nursing homes with telehealth, a major hospital network is looking to market its virtual interventions to a wider swath of post-acute and long-term care facilities. Northwell Health, the largest health care provider in New York State, saw rehospitalizations decline by up to half at […]
The Centers for Medicare & Medicaid Services (CMS) on Friday announced the finalization of a new kidney-care payment rule, but the regulation specifically exempts patients who are receiving their dialysis treatment in the nursing home. The End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model is intended to test whether greater use of home dialysis and […]
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 […]
As COVID-19 continues to bring sickness and death to American nursing homes, Harvard University professor David Grabowski has become one of the most-quoted experts on the steps that operators and the government should take to stem the tide. But as the summer turns to fall during a pandemic that started in late winter, the long-term […]
Billions of federal stimulus dollars have kept the skilled nursing sector afloat during the COVID-19 pandemic, but as the most recent distributions hit operators’ bank accounts, storm clouds are still gathering in the distance. While nursing home operators may have been spared the immediate financial woes that hit businesses in a variety of other sectors, […]
The rising tide of managed care enrollment for both Medicare and Medicaid patients continues to swell, and as the nation grapples with the costs of the pandemic, SNFs should be aware of the moves states might make to implement some type of managed care model as they try to secure budgetary stability. The steady increase […]