As the Medicare Advantage (MA) program has continued to grow over the last decade, so too have Institutional-Special Needs Plans (I-SNPs) for care rendered in nursing homes or other long-term care settings. However, there may be slight shrinkage in store for these plans in 2025. According to a KFF analysis of CMS Landscape files, I-SNPs […]
American Health Plans
Optum is scaling back its Medicare Advantage Special Needs Plans for nursing home and assisted living residents in several regions. The health care services arm of insurance giant UnitedHealth Group (NYSE: UHG), Optum, made headlines earlier this year for workforce cuts. Now, the company is shutting down Institutional Special Needs Plans (I-SNPs) in several states, […]
In weathering the rise of managed care penetration – which has often meant lost profits – nursing homes are turning to centralized processes for handling claims, beefing up teams to handle additional documentation requests (ADRs), and closely tracking contract renewals. Rates for managed care plans like Medicare Advantage are often lower than traditional fee-for-service Medicare […]
Capital Funding Group (CFG) financed more than $440 million in the first half of this year, including 18 health care bridge loans, five multifamily bridge loans and eight HUD loans. Notable transactions included a $42 million HUD financing package for three skilled nursing facilities in Washington and Idaho, along with a $36.2 million bridge-to-HUD loan […]
In this Clinical Dashboard interview, Skilled Nursing News sits down with Tom Coble, Chief Strategy Officer at American Health Plans. Coble holds over 25 years of experience in health care and has been a key pioneer in developing Medicare Special Needs plans. Coble shares his take on his ideal Clinical Dashboard, which includes proactive measures […]
As a physician assistant and current vice president of TruHealth, which serves as the clinical team for national I-SNP and Medicare Advantage operator American Health Plans, Bridget Grover’s day-to-day experience is driven by clinical needs among the aging population. In this Clinical Dashboard interview, Grover shares her insights based on being a partner to hundreds […]
A big question that operators must ask themselves when considering involvement in an institutional special needs plan, or I-SNP, is ultimately wrapped up in how much money is being made on the Medicare Part B therapy side, some say. It might not make financial sense to sign up for an I-SNP if a SNF operator […]
As the skilled nursing industry shifts towards managed care plans like Medicare Advantage and Medicaid managed care, “conveners” have become essential in managing care for specific patient populations, especially for long-term care residents and dual-eligible individuals. And while conveners have helped nursing homes and health care providers adapt to the changing landscape and achieve better […]
In this Payment Perspectives interview, Skilled Nursing News is joined by American Health Plans Chief Development Officer Hank Watson to talk about what health care providers need to do differently when it comes to payment evolution. He explains how skilled nursing providers can show their value to payers, and he also debunks the common myths […]
by Paul Bergeron Skilled nursing providers are facing an extremely challenging operating environment, but they must keep adapting and innovating as the shift toward value-based care continues across the U.S. health care system. And in fact, providers have tremendous opportunities to seize. “Value-based care through the population health management model is the most exciting thing […]
This article is sponsored by American Health Plans. In this Voices interview, Skilled Nursing News sits down with American Health Plans Vice President of Operations Jason Haney to learn why SNF operators are increasingly turning away from insurer-owned Medicare Advantage institutional special needs plans (I-SNP) and moving into owning these plans themselves. Haney offers his […]
The Future Leaders Awards program is brought to you in partnership with PointClickCare. The program is designed to recognize up-and-coming industry members who are shaping the next decade of senior housing, skilled nursing, home health and hospice care. To see this year’s future leaders, visit https://futureleaders.agingmedia.com/. Jason Haney, Vice President of Operations at American Health […]
American Health Partners, which operates 29 skilled nursing and senior living facilities among other post-acute ventures, on Wednesday announced its acquisition by the Mitchell Family Office (MFO). The Birmingham, Mich.-based MFO explicitly pointed to the diversity of American Health Partners’ holdings as a reason behind inking the deal. In addition to its brick-and-mortar senior health […]
Simply maintaining day-to-day operations at a nursing facility in 2020 was a herculean task, but several providers were able to also execute on the roll-out of an I-SNP, a special kind of Medicare Advantage plan for long-term care residents that proponents say provide both clinical and financial benefits to individual facilities. Hank Watson, chief development […]
The average U.S. nursing home has operated in a kind of survival mode for the last year, with long-term goals around new clinical and reimbursement models shoved aside to tackle the immediate and persistent scourge of COVID-19. That said, some facilities were still able to execute on previously developed strategies to enter the world of […]
Forward-thinking skilled nursing providers have increasingly warmed to the idea of starting a special kind of in-house Medicare Advantage plan in order to take more control over their reimbursements in an uncertain environment. But the strategies that operators must adopt to succeed with Institutional Special Needs Plans (I-SNPs) also fit seamlessly into preparations for the […]
Subscribe
Receive industry updates and breaking news from SNN.