I-SNP Exec: Skilled Nursing Operators Must Approach Insurers to Succeed — But Few Do

Skilled nursing operators frequently bemoan the shorter lengths of stay and lower daily payment rates for Medicare Advantage residents, but the leader of one plan says it’s also up to providers to present novel ideas to insurance executives. Before taking the CEO role at the nursing-home focused Longevity Health Plan earlier this year, René Lerer […]

Number of I-SNP Plans Goes Up Almost 30% Year-Over-Year

The number of skilled nursing providers interested in becoming insurers has grown for the past several months. Now hard numbers show just how great that interest is. Special needs plans are a category within Medicare Advantage (MA) that provide a common framework for the plans that serve special-needs beneficiaries, while also expanding beneficiary choice and […]

PDPM Countdown: ‘We Are All Crossing Our Fingers and Knocking on Wood’

With the Medicare Part A reimbursement overhaul taking effect in just a few months, skilled nursing providers across the country are in countdown mode. But the clock is moving at different paces for different providers, several experts said. Some SNFs began their analysis and preparations months ago; others are barely getting started. That’s led to […]

Sitting Out Bundled Payments Could Leave Skilled Nursing Providers Far Behind

For many skilled nursing providers, the launch last week of the 2020 application period for the government’s flagship bundled-payment program was low on the list of priorities. After all, under the new Bundled Payments for Care Improvement Advanced (BPCI Advanced) model, nursing homes can’t be episode initiators, meaning hospitals and other acute-care providers are the […]

Genesis Exec: Skilled Nursing Industry Has No Choice But to Embrace New Models

It’s an existential problem that many providers face in the skilled nursing industry: New payment models demand substantial operational changes, but the current fee-for-service reality determines how they can pay and plan for those shifts. This frustrating dichotomy was on full display during a panel discussion on Institutional Special Needs Plans (I-SNPs) and other new […]

Listen to the Rethink Podcast #2: CEO Anne Tumlinson

The second episode of our podcast, Rethink, is now available! From the federal government to Avalere Health to the advisory firm that bears her name, Anne Tumlinson has been a leading voice on the business of long-term health care in the United States. As CEO of Anne Tumlinson Innovations, she hears from providers around the […]

Why Skilled Nursing Providers Could Embrace Shorter Lengths of Stay

As Medicare Advantage plans continue to pressure skilled nursing operators, one prominent leader in the space predicts that innovative providers can survive by leaning into the changes. By transforming their facilities into standalone medical-surgical facilities that can replace similar units in hospitals, SNFs can evolve into purely short-stay health care providers that thrive in the […]

Without Incentive to Share Savings, ACOs Add to SNFs’ Financial Headaches

It’s been a common refrain in the industry: To survive in a health care system increasingly moving to value-based payment models, skilled nursing facilities will have to form strong partnerships with hospitals, health systems, and accountable care organizations (ACOs). But doing that will be difficult if acute care facilities and ACOs aren’t interested in forging […]

Long-Term Care Providers Drive Growth in Special Medicare Advantage Plans

SNN presents this guest analysis from Anne Tumlinson and Elizabeth Walsh of Anne Tumlinson Innovations. Health care providers selling Medicare Advantage (MA) products isn’t a new trend, but typically “providers” refers to hospitals, health systems, or physician groups. Few would expect nursing homes and assisted living operators to be able or willing to manage health care […]

When Hospitals Build Skilled Nursing Networks, How Narrow is Too Narrow?

Skilled nursing providers have faced pressure to break into area hospitals’ top-tier referral groups — the increasingly select few deemed fit to manage acute care operators’ patient populations across the continuum. But when SNFs size up their competitors in their marketplaces, are they facing off for a slot in a hospital’s top five, or top […]

Skilled Nursing Admissions Dropping in Tandem with Lower Hospital Use

Admissions to skilled nursing facilities have declined in a manner consistent with a drop in inpatient hospital usage, according to the Medicare Payment Advisory Commission’s (MedPAC) most recent data book. That’s just one of the conclusions from the statistics, released last month by MedPAC — a non-partisan agency that advises Congress on Medicare issues.  For […]

Managed Care Plans See Skilled Nursing as a Commodity, Not a Partner

Experts are increasingly calling on skilled nursing facilities to step up and tout their worth in the new value-based health care landscape. But skilled nursing facilities may not have that much influence to wield, particularly when it comes to the growing force of managed care, one expert says. “As an industry, SNFs have no leverage […]

Two Visions of the 21st Century Skilled Nursing Facility

The skilled nursing world is in upheaval, but too many providers are complacently running the skilled nursing facility of yesterday rather than creating a successful model for the future. That’s according to Anne Tumlinson, founder of consultancy Anne Tumlinson Innovations and a nationally recognized authority on post-acute and senior care. She previously led Medicaid oversight […]