New Eventus CEO: Though ‘Neglected’ in Alternate Payment Models, Nursing Homes Can Outperform Hospitals

Once wary of accountable care organizations (ACOs) and other new payment models, nursing home owners and operators are beginning to turn in favor of these value-based care structures — in the hopes of gaining leverage in a complex skilled nursing market burdened by high costs of care and staffing pressures. And although the push to […]

SNF Providers Could Find Managed Care Relief By Banding Together in IPAs

Creating or joining an independent practice association (IPA) empowers providers to negotiate managed care plan services and rates, a potential game-changer for nursing home owners amidst Medicare Advantage headaches — pains that include shorter lengths of stay, or the elimination of skilled nursing stays altogether in favor of home care.  Providers might opt into an […]

Winners Still Outnumber Losers in Latest PDPM Analysis, But Length of Stay Trends Could Erase Rate Gains

The latest analysis of the new Medicare payment model for nursing homes again shows more operators scoring gains than suffering losses, but the change from the previous system may not be quite as straightforward — particularly as fee-for-service Medicare continues to lose ground to other payment sources. A little more than 67% of skilled nursing […]

Tips for Early PDPM Success: Demand More Data from Hospitals, Market Higher-Acuity Services

The early returns for the new Medicare nursing home payment model have been positive, but providers aren’t seeing gains by sitting back and watching the changes. Several key strategies for success have emerged in the Patient-Driven Payment Model’s first four months, with a particular focus on data — as well as clearly communicating the availability […]

Skilled Nursing Finance Vet: If CMS Isn’t ‘Measured’ on Medicaid Crackdown, Operators Face ‘Quite a Blow’

When it comes to the buying, selling, and financial backing of skilled nursing facilities, the new chief development officer of Senior Living Investment Brokerage has seen all angles. Steve Gilleland, who joined the Glen Ellyn, Ill.-based SLIB at the beginning of the month, worked on the lending side of skilled nursing and senior housing in […]

Payment Outlook: 60% of MA Plans Cover Telehealth, 95% of Post-Acute Providers Subject to Alternate Models

The new fee-for-service Medicare model absorbed much of the oxygen around nursing home payment reform in 2019, but 2020 — as well as the years beyond — will bring a slew of alternate payment pressure to the post-acute sector. Over the next two years alone, 95% of post-acute operators will find themselves in new payment […]

CMS to Merge Nursing Home Compare into Single, Cross-Continuum Database

The federal government on Thursday announced a major shake-up to its consumer-facing database of skilled nursing facility quality information, revealing plans to merge Nursing Home Compare into a more comprehensive website that features data about care sites across the continuum. Sometime later this year, the Centers for Medicare & Medicaid Services (CMS) will combine all […]

Why 2020 Could Be the Year of PDPM Exits — and the Skilled Nursing-Led ACO

The consulting firm Avalere Health, based in Washington, D.C., has had a front-row seat for the changes shaping the health care world, including the post-acute sphere. For skilled nursing facilities, many of those changes have felt like one punch after another, ranging from the rise of Medicare Advantage enrollment to the federal government’s encouragement of […]

Genesis Continues ACO Push with Senior Living Properties Partnership

National skilled nursing giant Genesis HealthCare (NYSE: GEN) continued its drive to bring more outside operators into its accountable care organization (ACO) this week, announcing a new accord with Senior Living Properties. Under the terms of the deal, the Fort Worth, Texas-based Senior Living Properties will see some of its buildings — along with select […]

Three Months into PDPM, Teasing Out Therapy Opportunities — and Fixing Common Mistakes

Three months into the Patient-Driven Payment Model (PDPM), operators are still strategizing how to best streamline coding and reimbursements. Some are beginning to glean positive results with increased margins, whether it’s through an increase in more efficient group and concurrent modalities or a reduction in therapy headcounts — or both. But operators still have areas […]

Pending Part B Changes Could Have Major Impact on Nursing Home Finances, Therapy Staffing

Early returns for the new Medicare Part A reimbursement system for nursing home operators appear positive, but some industry advocates warn that more Part B pain could be coming over the next few years, both for therapists and skilled nursing providers. And although the exploding senior population represents heavy demand for therapy services, some leaders […]

Editor’s Take: Skilled Nursing Industry Shouldn’t Block Out the Long-Term View When Making PDPM Changes

Just about every major policy change, no matter how well intentioned, has butterfly effects that no one can foresee — along with changes that, while foreseen, still can cause real harm to real people. The news of therapy layoffs and hour reductions that swept through the skilled nursing world earlier last year fell into the […]

CMS Chief Medical Officer to Leave for Role With Insurance Giant Humana

The chief medical officer at the Centers for Medicare & Medicaid Services (CMS) will be leaving the agency next month to take a new position with health insurance heavyweight Humana (NYSE: HUM). Modern Healthcare first reported the news Thursday. CMS confirmed to Modern Healthcare that Goodrich, who has also served as director of the Quality […]

Skilled Nursing Executive Outlook: ‘Question of Nursing Homes’ Viability Will Continue’ in 2020

Though the early days of 2020 have brought some optimism around the state of the post-acute and long-term care industry, executives in the space continue to emphasize that the coming 12 months could bring make-or-break decisions for operators and their partners. One day after American Health Care Association (AHCA) CEO Mark Parkinson told SNN that […]

AHCA’s Parkinson: PDPM is Running Above Budget-Neutral, But Clawbacks Aren’t Inevitable

Early analyses of the new Medicare payment model for nursing homes indicate that operators may be pulling in more money than the federal government intended — leading to widespread speculation that adjustments could be coming sometime in 2020. American Health Care Association (AHCA) president and CEO Mark Parkinson agrees with the idea that the Patient-Driven […]

Verma: Overhaul Led to Significant Growth in ACOs Taking on Risk, But Verdict Out on Spending

A federal overhaul to the Medicare Shared Savings Program (MSSP), implemented late in 2018, has led to an increase in the number of accountable care organizations (ACOs) taking on downside risk. The redesign of the program, dubbed “Pathways to Success,” generally required new ACOs to take accountability for spending increases after two years; previously ACOs […]

Confessions of a Therapist Post-PDPM: ‘You’re Not Valuable to Them Because You’re Not Making Money’

Among the many early takeaways from the new Patient-Driven Payment Model (PDPM), perhaps the most immediate was its effect on rank-and-file therapists who work at skilled nursing facilities. Almost instantly after the PDPM shift on October 1, Skilled Nursing News received a flurry of e-mails from therapists who were laid off or saw their hours […]