Amid Medicare Advantage’s Growth, I-SNPs See Slight Dip for 2025 

As the Medicare Advantage (MA) program has continued to grow over the last decade, so too have Institutional-Special Needs Plans (I-SNPs) for care rendered in nursing homes or other long-term care settings. However, there may be slight shrinkage in store for these plans in 2025. According to a KFF analysis of CMS Landscape files, I-SNPs […]

Nursing Home Providers Adjust to Optum Exiting Medicare Advantage I-SNPs in Several Regions

Optum is scaling back its Medicare Advantage Special Needs Plans for nursing home and assisted living residents in several regions. The health care services arm of insurance giant UnitedHealth Group (NYSE: UHG), Optum, made headlines earlier this year for workforce cuts. Now, the company is shutting down Institutional Special Needs Plans (I-SNPs) in several states, […]

Longevity, Infinity Announce Joint Venture Focused on I-SNP Expansion in Nursing Homes

Longevity Health and Infinity Healthcare Consulting on Wednesday announced a joint venture for institutional special needs plans (I-SNPs), marking Longevity’s entry into three new states, along with the expansion of its existing business into an additional state. Longevity and Infinity’s clients will collaborate to assist I-SNP members living in Infinity nursing facilities across Indiana, Kentucky […]

‘Money Out of Our Pockets’: $274.9M in Nursing Home Revenue Lost For Every Percentage MA Plans Grow

As Medicare Advantage continues to grow in the skilled nursing space, beneficiaries utilizing traditional Fee-For-Service Medicare have declined, and in turn reimbursement has dropped at an alarming rate. For every two beneficiaries that opted for MA, one FFS individual left the program in 2023, the first year the number of FFS beneficiaries declined in every […]

Inside the I-SNP Journey: Nursing Home Operators Unlock Promise of Medicare Advantage with 3 Different Models  

As nursing home organizations adjust to a changing environment of reimbursement, Medicare Advantage Institutional Special Needs Plans (I-SNPs) are undergoing rapid growth, with operators pursuing distinct strategies meant to realize financial and operational gains. The benefits of an I-SNP can range from more control over quality, happier clinical staff, reduced administrative burdens, improved compensation and […]

‘Multidisciplinary’ Resident-Centered Care Is Crucial To Minimizing and Correcting Survey Deficiencies at Nursing Homes

Although survey citation rules can vary from state to state, nursing home operators can implement broad steps to avoid deficiencies if they focus on the often overlooked easy fixes as well as the more complicated overlaps between disparate areas of care – ranging from food safety and mental health documentation to infection control. Certain trends […]

CMS Proposal Marks Shift After Years of Skilled Nursing Frustration with Medicare Advantage Diversions

The Centers for Medicare & Medicaid Services (CMS) has decided to take action on transitions in care – specifically Medicare Advantage (MA) plans diverting care to home health instead of skilled nursing – after years of skilled nursing industry and consumer feedback. CMS last month took steps to address the trend with a proposed rule […]

Every Dollar Counts: How Operators Can Capitalize on the SNF Value-Based Purchasing Program

Accurately completing assessments and charting patient care should be more of a priority for skilled nursing facilities moving forward. Not only because operators are facing more MDS coordinator shortages and are outsourcing the process as a result, but also reducing hospital stays could be one way SNFs capitalize on value-based care. At least that’s the […]

Telehealth Opening Doors For Smaller Operators To Join I-SNP Networks

As the I-SNP model continues to expand across the skilled nursing industry, some see it as one way to effectively push telehealth services into smaller, rural facilities that don’t have the infrastructure to support the services by themselves. “We’re seeing a lot of traction in the I-SNP model,” TapestryHealth Co-Founder and Chief Growth Officer Mordy […]

Executive Outlook 2022: Nursing Homes Need to Diversify to ‘Not Only Survive, but Thrive’

Nursing homes have long been seen as the place where elderly Medicare and Medicaid patients spend their final years, but as these institutions look to evolve post-COVID, their role in the long-term care continuum continues to expand. Over the course of the year, SNN has seen operators open in-house dialysis units, renovate their facilities for […]

I-SNP Provider Longevity Health Expands Reach in Florida, Illinois and New Jersey

Longevity Health Plan, a leading independent provider of Medicare Advantage (MA) institutional special needs plans (I-SNP) in the skilled nursing industry, announced this week that it will be expanding its reach in Florida, Illinois and New Jersey. Longevity will now offer I-SNPs in 300 additional nursing homes comprising more than 33,000 beds for coverage effective […]

Value-Based Medicare Advantage Payment Plans ‘Only Going to Increase’

There’s a strong possibility that Medicare will move to mandate value-based payment models (VBP) for the nursing home industry in the years to come, according to industry executives. Dr. René Lerer and Brian Cloch, CEOs for Longevity Health Plan and Transitional Care Management, respectively, spoke at a panel on the future of VBP models during […]

Leading I-SNP Provider Longevity Health Moves Into Michigan

Longevity Health Plan, one of the nation’s leading independent providers of Medicare Advantage (MA) institutional special needs (I-SNP) plans in the skilled nursing industry, announced this week that it will be expanding into Michigan next month. It plans to offer I-SNP plans across 16 counties in the state. “We are pleased to partner with forward-thinking […]

As Post-Acute Care Shifts Home, I-SNPs See Case for Expansion to Meet Growing Long-Term Share

The COVID-19 pandemic brought an unrelenting spotlight to clinical care in skilled nursing facilities — one that will shine in the form of government audits and investigations before the immediate crisis ends and long after it passes. But several operators had trained their sights on clinical care within their facilities before the start of the […]

I-SNPs vs. ACOs: Balancing the Skilled Nursing Risks, Rewards of Two Hot Payment Models

As the skilled nursing industry struggles to adapt to a new Medicare payment landscape, in-house Medicare Advantage plans have emerged as one of the hottest topics among leaders — while the space’s publicly traded behemoth has thrown its full support behind the separate accountable care organization (ACO) model. There may not be one set answer […]

‘It’s Not That Easy’: What Skilled Nursing Operators Should Consider Before Launching — or Joining — an I-SNP

On paper, a skilled nursing facility starting its own specialty Medicare Advantage plan sounds like an easy decision: In an era of tight reimbursements, staffing pressures, and length-of-stay declines, why not control the payment source that so frequently vexes them? But according to René Lerer, the calculus for Institutional Special Needs Plans (I-SNPs) just isn’t […]