Instead of Saving $1.7 Billion, ACOs Cost Medicare $384 Million

Accountable care organizations (ACOs) are supposed to represent an innovative way to cut costs and improve care. But a new study found that on at least one of those counts, ACOs may be doing more harm than good. The Medicare Shared Savings Program (MSSP) increased federal spending by $384 million between 2013 and 2016, according […]

Skilled Nursing Providers Must Brace for Medicare Advantage Wave

Medicare Advantage isn’t going away, and skilled nursing facilities need to be prepared for the resulting operational challenges, according to a new report from Lancaster Pollard (LP). LP, a Columbus, Ohio-based financial firm, pointed to recent troubles at Kindred Healthcare (NYSE: KND), which announced its exit from the skilled nursing industry in 2017; Genesis Healthcare, (NYSE: […]

Skilled Nursing Must-Reads: A Nursing Home for Parolees

Start your week with a look at some of the most interesting skilled nursing stories from around the web, including a SNF with a unique clientele in Connecticut. SNF that serves parolees wins case A skilled nursing facility that serves prison parolees in the suburbs of Hartford, Conn. won a court ruling this week against […]

Five Star’s Skilled Nursing Revenue Takes Hit in Q4

Skilled nursing occupancy troubles hit Five Star Senior Living (Nasdaq: FVE) in the fourth quarter, bruising the company’s earnings. The Newton, Mass.-based senior living operator saw a $2.7 million decrease in skilled nursing revenue, mostly from its leased standalone skilled nursing facilities. Occupancy at the leased SNFs dropped to 78%, down 220 basis points from the […]

Inside Cleveland Clinic’s Skilled Nursing Strategy

The Cleveland Clinic followed a familiar path to boost its care coordination efforts, building partnerships with trusted skilled nursing facilities and relying on its own staff to ensure quality. And the Ohio-based health care provider has the results to prove that the model can work. “What our data has told us, and has been consistent […]

Senators Issue Bipartisan Call to Move Away from Fee-For-Service Medicare

A pair of United States senators asked new Health and Human Services Secretary Alex Azar to focus on developing alternative payment models for Medicare — while moving away from traditional fee-for-service (FFS) Medicare. “As the largest purchaser of health care in the United States, the federal government needs to send a strong signal that paying […]

Staffing Efficiency, Flexibility Key to Future Skilled Nursing Success

A recent report puts some hard numbers to the pressures skilled nursing facilities face — and offered a prediction of its own about the much-anticipated “silver tsunami.” Though occupancy has been declining in skilled nursing facilities, falling from 87% in 2015 to 82% in 2016, the report from accounting and consulting firm Plante Moran projected […]

Skilled Nursing Use Unchanged by Medicare Advantage Cost-Sharing Caps

Limiting out-of-pocket costs for skilled nursing services under Medicare Advantage plans doesn’t appear to affect the use of SNF services. Specifically, when a team of researchers compared MA plans with mandatory cost-sharing reductions and those without, they found little difference in the use of SNFs. The findings, published online on March 12 in the Journal […]

Providers Push Back Against MedPAC’s ‘Blunt’ Proposed Cuts

The most recent report from the Medicare Payment Advisory commission (MedPAC) claims that skilled nursing reimbursements are too high, but one leading trade group says MedPAC’s own numbers paint a much bleaker picture. Data in the report showed that the total margins for freestanding skilled nursing facilities were 0.7% in 2016, down from 1.6% in 2015. […]

Skilled Nursing Operators Fighting for Share of Shrinking Medicare Pool

The number of skilled nursing stays among Medicare recipients dropped 15% over the last several years — but not necessarily for the reason many in the industry might believe. Instead of lower-cost options like home health cutting into demand for nursing home services, the post-acute sector in general is seeing declines amid an overall drop in […]

MedPAC: Congress Should Cut Medicare Rates for Skilled Nursing Facilities

Citing high Medicare margins and concerns over therapy services, the Medicare Payment Advisory Commission (MedPAC) has asked Congress to cut reimbursement rates for skilled nursing facilities. The non-partisan agency called on Congress to scrap the Medicare market basket rate increases for fiscal years 2019 and 2020 — which would amount to 2% and 2.1%, respectively […]

How In-House Insurance Plans Can Boost Skilled Nursing’s Fortunes

In an era of record-low skilled nursing occupancy and rapidly shifting payment models, some operators have found a single solution to both problems: an in-house insurance plan. Skilled nursing providers can create their own institutional special needs plans (I-SNPs), a type of Medicare Advantage program specifically designed to cover beneficiaries who are confined to an institution […]

Provider Organizations Express Concerns With Bundled Payments Program

Not allowing post-acute care (PAC) providers to take the lead in the Bundled Payments for Care Improvement Advanced (BPCI Advanced) program will hamstring the government’s ability to improve savings and care, several associations argued in a letter to the Center for Medicare and Medicaid Innovation (CMMI). LeadingAge and other prominent long-term care associations raised concerns about […]

What the Rise of Medicare Advantage Means for Skilled Nursing

About 33% of seniors enrolled in the Medicare program have elected to use managed Medicare Advantage plans, and that number is expected to grow — potentially faster than the government thinks. The Congressional Budget Office has predicted growth in MA plans by about 4% per year, but Dan Mendelson, president of Avalere Health, says his […]

MedPAC Debates Troubling Post-Acute Referral Patterns

You can lead patients to a high-quality post-acute care (PAC) provider, but you can’t make them decide to go there. That was a primary takeaway in a wide-ranging discussion at the Medicare Payment Advisory Commission’s (MedPAC) March public meeting that focused on how to steer beneficiaries into higher-quality PAC facilities. “Medicare statute provides beneficiaries with […]

HHS Secretary Wants Providers to Take Amazon, Yelp’s Lead

If Health and Human Services secretary Alex Azar has his way, the health care consumer of the future will select providers the way they currently decide where to eat or which knockoff iPhone charger to buy. “Imagine a day when health care delivery in the United States functions the way other parts of our economy […]

ACOs Gain by Shifting Money Away from Skilled Nursing

Skilled nursing providers have long been wary of accountable care organizations (ACOs), fearing that the models’ emphasis on cost-sharing might drive dollars away from their buildings. And a new study shows that those concerns might be grounded in reality. For every 1% that a given ACO cut skilled nursing spending, the overall savings rate increased […]

Industry Responds to Democrats’ Call for Skilled Nursing Scrutiny

In a Valentine’s Day letter to top health officials, a group of influential Senate Democrats asked the Centers for Medicare & Medicaid Services (CMS) to reconsider certain rollbacks of nursing home regulations. In response, a leading industry group on Wednesday wrote back to the senators to clarify and rebut some of their points. “We think […]