Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure noted higher participation in value-based payment models like Institutional Special Needs Plans (I-SNPs) during a recent discussion with HealthAffairs, but also hinted that consolidation of such programs may be needed. “Too many models in too many places that aren’t coordinated with each other,” is how […]
Avalere Health
Members of the U.S. House of Representatives this week introduced bipartisan legislation to strengthen Medicare’s value-based care models and accountable care organizations (ACOs), among other alternative payment models (APMs). Doctors, hospitals and other providers make up an ACO — the group coordinates care for Medicare patients while limiting extraneous services and preventing medical errors. The […]
The ultimate role skilled nursing facilities will play in the post-acute care continuum coming out of COVID-19 remains to be seen. Home-based care utilization has skyrocketed over the past year, partly due to favorable policies out of the Biden administration and shifting referral-source preferences. Meanwhile, most SNF operators continue to battle back from the sudden […]
Four months into the Patient-Driven Payment Model (PDPM), the first cases of COVID-19 were found in the U.S. – and any chance of the Medicare overhaul going as planned was gone. The new system for Medicare reimbursement for skilled nursing facilities, which took effect in October 2019, was designed to be budget-neutral, meaning that the […]
The Centers for Medicare & Medicaid Services (CMS) begins the summer with a new administrator, Chiquita Brooks-LaSure. Soon, the skilled nursing industry will begin to see how this new agency leader — who has a history with CMS and the Department of Health and Human Services (HHS) — will shape nursing home policy and regulation. […]
During Covid-19, skilled nursing facilities have seen their admissions squeezed as more patients have gone straight from hospitals to their own homes for recovery. But more complex cases are also being diverted away from SNFs, toward inpatient rehabilitation facilities (IRFs) and long-term acute-care hospitals (LTACs). It’s a trend highlighted in an analysis from consulting firm […]
In the early days of the COVID-19 pandemic, the federal government issued a range of waivers to help the health system care for patients without being overwhelmed. One of those waivers removed a common barrier to skilled nursing care: the requirement that a patient have a three-day inpatient hospital stay for Medicare to cover the […]
The federal authorities that regulate skilled nursing facilities issued a slew of changes to the rules governing nursing home care in the early months of spring as part of efforts to curb the spread of COVID-19 in the facilities. Some of those changes, such as the loosening of restrictions around the use of telemedicine, are […]
While the skilled nursing landscape continues to struggle both operationally and financially during the COVID-19 pandemic, those same negative forces have only served to strengthen private health plans — putting Medicare Advantage in an even better position to continue its growth. Cratering census and sharp declines in elective surgeries, while fiscally devastating for nursing homes, […]
The COVID-19 pandemic pummeled patient volumes across the health care continuum, but for skilled nursing facilities, the sharp decline in patients has not rebounded, according to a new analysis — even as hospitals and home health see their admissions recover. Discharges to SNFs and to the home health setting fell in tandem with the decline […]
Skilled nursing facilities, and post-acute providers in general, will feel pain even beyond the immediate short-term challenges of protecting residents and staff from the spread of the novel coronavirus, several experts predicted Thursday. The Centers for Medicare & Medicaid Services late on Wednesday recommended the delay of “all elective surgeries, non-essential medical, surgical, and dental […]
The new fee-for-service Medicare model absorbed much of the oxygen around nursing home payment reform in 2019, but 2020 — as well as the years beyond — will bring a slew of alternate payment pressure to the post-acute sector. Over the next two years alone, 95% of post-acute operators will find themselves in new payment […]
The consulting firm Avalere Health, based in Washington, D.C., has had a front-row seat for the changes shaping the health care world, including the post-acute sphere. For skilled nursing facilities, many of those changes have felt like one punch after another, ranging from the rise of Medicare Advantage enrollment to the federal government’s encouragement of […]
The 20th episode of our podcast, Rethink, is now available! The Patient-Driven Payment Model — and all the changes that came with it — officially arrived for skilled nursing providers in October 2019. The new Medicare reimbursement system for SNFs was top of mind throughout the year, but 2020 will bring a variety of new challenges, […]
Increasing demand for skilled nursing services is a good sign for the industry, according to several experts who spoke on SNN’s annual outlook webinar, but a continued squeeze on margins may affect some facilities’ ability to keep their doors open in 2020. Although the Patient-Driven Payment Model (PDPM) looks like good news, with increased reimbursements […]
When the Centers for Medicare & Medicaid Services (CMS) moved to allow Medicare Advantage plans to cover more options for care at home, skilled nursing providers could be forgiven for not paying much attention. It’s a move with more immediate impact to home care and home health companies, as well as senior living providers. Medicare […]
For one skilled nursing operator in the greater Chicago area, success in the world of accountable care organizations has meant education and proactive collaboration — as well as a willingness to drop out of a partnership with an ACO that didn’t fit into its overall philosophy. “We really look for a partnership in the ACO, […]
The federal government released a breakdown of strategies that accountable care organizations (ACOs) have used to successfully partner with skilled nursing facilities — a move that could indicate policymakers’ continued support of the care models. The Centers for Medicare & Medicaid Services (CMS) recently released a care coordination toolkit for ACOs that drew from focus […]
Accountable care organizations (ACOs) need time to work out their growing pains before producing savings for the government, according to a new study from a top health care consulting firm — and a major assumption about risk might not actually be true. ACOs active for four years or longer accounted for just about all of […]
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 […]
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