Rapid Medicare Advantage Expansion into Home Health, Senior Living Could Accelerate Pressures on Skilled Nursing

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 […]

CMS Shares Strategies for Successful Collaborations Between ACOs, Nursing Homes

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 […]

Savings Success in ACOs Takes Time, and Risk Might Not Matter

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 […]

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 […]

Specialized Skilled Nursing Operators to Benefit from New CMS Payment Model

The new Patient-Driven Payment Model (PDPM) for skilled nursing facilities will require a strategic shift away from the volume of services provided to a focus on patient needs, and a new analysis from Avalere Health says providers should start breaking down their patient data now in order to adapt. Some providers could see Medicare reimbursements decrease […]

Medicare Advantage Beneficiaries Do Better On Outcomes, Costs

Patients enrolled in Medicare Advantage programs outperformed traditional fee-for-service (FFS) on several key quality measures, according to a new report from Avalere. MA beneficiaries in Avalere’s study had 23% fewer inpatient stays and 33% fewer emergency room visits than FFS Medicare beneficiaries. MA beneficiaries received more preventive physician tests and services, while FFS Medicare beneficiaries […]

Two-Sided Risk Key to Telehealth’s Promise in Skilled Nursing

Telehealth has promise for long-term care facilities in rural areas, but a new risk model may be needed to fully realize the technology’s potential, according to testimony at a hearing before the U.S. House Ways and Means Committee that focused on innovation in health care. Rep. Adrian Smith, a Nebraska Republican, noted the significance of […]

Instead of Saving $1.7 Billion, ACOs Cost Medicare $384 Million

Accountable care organizations (ACOs) are supposed to represent an innovative way to cut costs and improve care. But a new study found that on at least one of those counts, ACOs may be doing more harm than good. The Medicare Shared Savings Program (MSSP) increased federal spending by $384 million between 2013 and 2016, according […]

Skilled Nursing Operators Fighting for Share of Shrinking Medicare Pool

The number of skilled nursing stays among Medicare recipients dropped 15% over the last several years — but not necessarily for the reason many in the industry might believe. Instead of lower-cost options like home health cutting into demand for nursing home services, the post-acute sector in general is seeing declines amid an overall drop in […]

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 […]