The Trump administration’s communications freeze, which has indefinitely blocked a majority of external communications by the Centers for Medicare & Medicaid Services (CMS), continues to cause turmoil for nursing home operators. This freeze, imposed last week, has disrupted the flow of key health care data, and extends to several federal agencies, including the Centers for […]
ATI Advisory
The Centers for Medicare and Medicaid Services (CMS) proposed a 4.33% increase in payments to Medicare Advantage plans for 2026, which could have an overall positive trickle-down effect on nursing homes. Expected to be finalized under President-elect Donald Trump’s administration, this slight payment boost comes after MA providers faced a modest rate reduction for 2025. […]
Despite the sector continuing to grapple with staffing shortages, rising operational costs, and regulatory uncertainty, emerging trends have skilled nursing leaders gearing up for a positive 2025, with fewer challenges and more opportunities on the horizon. As we look ahead, several key trends are expected to shape the sector from regulatory shifts to financial turbulence, […]
The nursing home industry has been on a wild ride this past year, with major regulation up in the air and a flip in the White House leaving operators unsure of whether they should applaud or brace for impact. Rhetoric surrounding the federal minimum staffing mandate has changed drastically throughout the year, with leaders condemning […]
Surveyors will be evaluating for compliance in new ways, as a result of nursing home survey changes for 2025. While significant, these changes reflect federal initiatives that associations and operators have been seeing for some time now. Nursing home providers are parsing through recent, significant changes to the survey process and trying to grasp the […]
Negotiating power with Medicare Advantage (MA) plans may become easier as nursing homes explore participation in bundled payment options such as the Transforming Episode Accountability Model (TEAM), which enables following patients through an entire episode of care. It’s a lever available to participants and collaborators to forge new contracting strategies with their MA plan and […]
Delivering care to dual eligible nursing home residents can be complex with so many payers involved in the industry, but aligning incentives, quality measures and tools for providers can help operators serve this demographic. Dual eligible residents, or those that can receive benefits from both Medicare and Medicaid, often find themselves in a “tangled web […]
The crisis involving patients languishing at hospitals awaiting discharge into appropriate post-acute care settings has shown little signs of abating. The root causes of these discharge delays are manifold, but chief among them are workforce shortages at nursing homes. According to experts at a webinar hosted by ATI, the discharge crisis is amplified by a […]
The Centers for Medicare & Medicaid Services’ (CMS) in April released a bundled payment model that is the culmination of the best aspects from such past models, all to align with the agency’s efforts to get all Medicare Fee-for-Service beneficiaries involved in value-based care by 2030. The Transforming Episode Accountability Model, or TEAM, is considered […]
While Medicare Advantage (MA) has grown steadily in the last several years, leaders in the nursing home sector speculate whether increased federal regulation – and perhaps even more importantly, changes in the consumer experience – will slow its growth. This would come as a welcome development to many nursing home leaders, who have been struggling […]
The Centers for Medicare & Medicaid Services (CMS) is testing out a payment model that would cover all costs associated with an episode of care, including a skilled nursing stay, but it appears that select hospitals would be in the driver’s seat if approved. Certain surgical procedures will fall under the new model and include […]
The Centers for Medicare & Medicaid Services’ (CMS) recently proposed Value-Based Purchasing Program updates include staffing provisions that are being met with provider concern, although other updates should be well received once the dust settles. Among recommended changes, CMS is proposing allowing SNFs to review and correct Payroll-Based Journal (PBJ) data beginning with the fiscal […]
The federal government’s proposed Medicare payment increase for 2025 is not sitting well with the nursing home sector, with financial experts and operators raising concerns that the bump fails to compensate for inflation-induced operating costs – and a staffing proposal anticipated to cost in the billions each year. For some experts, the Centers for Medicare […]
Soaring costs associated with skilled nursing – and problematic payer sources – are making it harder for continuing care retirement communities (CCRCs) to provide such labor intensive post-acute care. CCRCs have to ask themselves some hard questions when it comes to what services they can reasonably offer, and if it’s worth it to keep open […]
Piece by piece, nursing home operators are seeing stricter government oversight of Medicare Advantage (MA) plans, a welcome relief given that partnerships with such managed care plans have become a huge source of administrative burden for providers in the sector, especially as workforce shortages persist. Most recently, the Centers for Medicare & Medicaid Services (CMS) […]
Given that a vast majority of long-stay nursing home residents are dual eligible for Medicare and Medicaid, residents and facilities alike can reap financial benefits while improving quality of care and reducing administrative burdens if federal and state policies better enabled a value-based care model that integrated the experiences of dual eligibles. This is the […]
The need for Medicaid as stopgap coverage for long-term care is more apparent when looking at differences in race, gender and ethnicity, and rural versus urban status of the residents. This is according to an analysis conducted by ATI Advisory, which identified the impact of disparities and differences in resources – finances, insurance and social […]
As nursing homes grapple with a tough economic and labor environment – which has forced closures and created access issues – patient and nursing home advocates underscored the emotional toll of care, calling upon the federal and state governments to do more to address new and emerging generational challenges to care. Anne Tumlinson, founder of […]
The latest proposed changes to the REACH accountable care organization (ACO) may make it even easier for skilled nursing facilities to be a part of an ACO program – and there may be implications for quality of care, industry leaders said. A broadened criteria and an attractive high needs population track is expected to be […]
Nursing home operators had a mixed reaction to the Centers for Medicare & Medicaid Services (CMS) final payment rule for 2024. While some operators said that they were generally appreciative of the 4% increase in Medicare reimbursement, they are also calling for more help and understanding from federal agencies in tackling the workforce crisis – […]