The proposed federal staffing mandate is a potential “kill factor” for nursing home providers, while the rise of Medicare Advantage (MA) is a “major challenge” — and how well the sector responds to these threats will play a major part in shaping the future. This is the perspective of Phil Fogg Jr., CEO of Marquis […]
Over-reliance on artificial intelligence is compromising post-acute care for nursing home residents on Medicare Advantage plans. This view of the problematic use of algorithms for prior authorizations – and denial based on incorrect assessment of patient needs – is at the center of reporting and analysis published in the health, medicine and life sciences publication, […]
Multiple managed care plans have made changes to their procedures for admissions to the skilled nursing setting amid the ongoing coronavirus pandemic, with several major companies suspending prior authorization requirements for admissions to a skilled nursing facility. The changes, however, are not uniform — and that’s if the managed care organization (MCO) chooses to make […]
After health care providers reported a range of issues with reimbursement, one of Kansas’s three managed Medicaid insurance companies promised improvement at a recent state government hearing. “Clearly, the feedback we’ve received and some of the issues that have been brought to our attention and some of the issues we’ve seen internally have been extremely […]
Every industry gathering has a theme, whether it’s an intentional move by the organizers or not. But the most illustrative conference experiences come when attendees and those in charge both can’t stop talking about the same subject — as was the case this past week at the National Investment Center for Seniors Housing & Care’s […]
Shares of pharmacy and insurance giant CVS Health (NYSE: CVS) slid on Wednesday after executives reported a $2.2 billion impairment charge related to its long-term health care business. The Woonsocket, R.I.-based CVS took the hit in the fourth quarter of 2018 due to troubles at its Omnicare arm, which provides pharmacy services to long-term health […]
The recent megadeals involving popular consumer brands and health care giants haven’t touched skilled nursing yet, but the moves are sending ripple effects through the industry as a whole — and SNF providers would be wise to listen up. When CVS acquired insurance giant Aetna and Amazon teamed up to form a health care company with […]
Observation stays at hospitals have been controversial in the long-term care world for their role in Medicare reimbursements, but a new study shows that they could save money on the private-pay side — a trend that could have consequences for both types of insurance models. Between 2009 and 2013, non-elderly patients affiliated with three major […]
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