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 […]
Anthem
The federal government on Monday announced the appointment of Brad Smith, a health care and insurance industry veteran, as the next head of the Center for Medicare & Medicaid Innovation (CMMI). Smith, previously the chief operating officer at insurance giant Anthem’s diversified business group, will additionally serve as senior advisor for value-based transformation to Department […]
If skilled nursing facilities want to improve their relationship with managed care payers — particularly the ever-expanding Medicare Advantage plans — they have to ensure that they understand the payers’ pain points. And they have to battle the reality that in the Medicare Advantage world, post-acute barely registers on insurers’ radar screens because it’s a […]
With record-low occupancy, rising labor costs, and other pressures eroding the bottom line, the need for nursing homes to innovate to survive has never been more pressing. In their quest for innovation, skilled nursing providers are turning to new partners, such as a Silicon Valley startup offering a solution to prevent residents from going to hospital emergency departments. […]