As Medicare Advantage continues to penetrate the nursing home market, leaders say that MA plans are depressing margins amid higher costs to run operations. This might lead some operators to contemplate closing, while others will be wiser to hire staff in designated roles to help them negotiate better rates – and exclusions – for managed […]
Medicare Payment Advisory Commission
Skilled nursing operators are presently eyeing a $320 million proposed decrease to Medicare funding at a time when a historic labor crisis and federal policies and rhetoric have a chance to make a mark on the industry for years to come. In just the last few months, the Biden administration unveiled its nursing home reform […]
The COVID-19 pandemic continued to put pressure on an already strained skilled nursing industry in 2021. The next 12 months will be yet another test of resilience. Looking ahead to 2022, SNFs must stay nimble and inventive to not only survive but thrive. Private equity will continue to lead the nursing home transaction market pack, […]
As Medicare Advantage enrollment continues to climb and operators look for a seat at the table, ProMedica Senior Care President Angela Brandt believes now is the time to recognize the role long-term care facilities can play in value-based payment. “We all have to get comfortable with where we add value for the health care continuum […]
As skilled nursing operators look for ways to build back hospital referrals, data shows that Medicare Advantage enrollment continues to climb, making some managed care experts wonder how smaller, traditional, single nursing home operators will be able to build a sustainable future. With Medicare Advantage enrollment now representing 46% of all 57.7 million eligible Medicare […]
Many Medicare providers have business structures that are complex, obscuring ownership and control, according to a new report from the Medicare Payment Advisory Commission (MedPAC). That’s a problem because the federal government’s process of enrolling or contracting with them has not caught up. In its June report to Congress, the commission examined the role of […]
The Medicare Payment Advisory Commission (MedPAC) once again advised that Medicare’s payments for skilled nursing facilities are too high — but also acknowledged the challenges for providers caused by low Medicaid reimbursement. A presentation by Dr. Carol Carter delivered to MedPAC on December 5 examined Medicare margins for SNFs amid the larger contexts of beneficiary […]
The federal government issued a final rule on Thursday requiring hospitals to give patients access to more information about the post-acute provider choices available — including data on how their post-acute options perform on quality measures such as pressure ulcers, falls, and readmissions. This new rule will not have any impact on anti-steering regulations that […]
The number of skilled nursing providers interested in becoming insurers has grown for the past several months. Now hard numbers show just how great that interest is. Special needs plans are a category within Medicare Advantage (MA) that provide a common framework for the plans that serve special-needs beneficiaries, while also expanding beneficiary choice and […]
Admissions to skilled nursing facilities have declined in a manner consistent with a drop in inpatient hospital usage, according to the Medicare Payment Advisory Commission’s (MedPAC) most recent data book. That’s just one of the conclusions from the statistics, released last month by MedPAC — a non-partisan agency that advises Congress on Medicare issues. For […]
The most recent report from the Medicare Payment Advisory commission (MedPAC) claims that skilled nursing reimbursements are too high, but one leading trade group says MedPAC’s own numbers paint a much bleaker picture. Data in the report showed that the total margins for freestanding skilled nursing facilities were 0.7% in 2016, down from 1.6% in 2015. […]
Citing high Medicare margins and concerns over therapy services, the Medicare Payment Advisory Commission (MedPAC) has asked Congress to cut reimbursement rates for skilled nursing facilities. The non-partisan agency called on Congress to scrap the Medicare market basket rate increases for fiscal years 2019 and 2020 — which would amount to 2% and 2.1%, respectively […]
You can lead patients to a high-quality post-acute care (PAC) provider, but you can’t make them decide to go there. That was a primary takeaway in a wide-ranging discussion at the Medicare Payment Advisory Commission’s (MedPAC) March public meeting that focused on how to steer beneficiaries into higher-quality PAC facilities. “Medicare statute provides beneficiaries with […]