As skilled nursing facilities work to build back hospital referrals lost during COVID, one way some are opening themselves up to new patients is by increasing their participation in managed care despite the tighter margins that come with it. With skilled nursing occupancy still below pre-pandemic levels, operators simply are no longer in a position […]
Guidance Care HMO
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 […]
Skilled nursing providers looking for a simple answer to how managed care plans will react to the new Medicare payment model will likely have to face an inconvenient truth: It’s complicated. Private Medicare Advantage insurers didn’t have to follow the old Resource Utilization Group (RUG) model when deciding how to reimburse for skilled nursing services, […]
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