The Trends That Will Shape Skilled Nursing in 2022

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, […]

Medicare Advantage Growth May Narrow Path Forward for Smaller SNF Operators

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 […]

Private Equity Surge in Health Care Highlights Shortcomings of CMS Ownership Reporting

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 […]

MedPAC Commissioner: Underfunding Turns Medicaid-Heavy SNFs into ‘7th Circle of Hell’

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 […]

New CMS Rule Requires Hospitals to Provide Skilled Nursing Quality Data at Discharge

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 […]

Number of I-SNP Plans Goes Up Almost 30% Year-Over-Year

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 […]

Skilled Nursing Admissions Dropping in Tandem with Lower Hospital Use

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 […]

Providers Push Back Against MedPAC’s ‘Blunt’ Proposed Cuts

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. […]

MedPAC: Congress Should Cut Medicare Rates for Skilled Nursing Facilities

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 […]

MedPAC Debates Troubling Post-Acute Referral Patterns

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 […]