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 […]
Accountable care organizations (ACOs) only generate savings for the government if they accept risk, according to an analysis from the Kaiser Family Foundation. ACOs generated net savings of $47 million in 2016, the Menlo Park, Calif.-based non-profit found in an independent analysis of publicly available ACO data and previously unpublished numbers from the Centers for […]
Annual expenditures on skilled nursing care will increase by 3.9% this year and keep rising through 2026, according to a new study from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. This rise in nursing home spending tracks with overall gains in outlays for health care services: Between 2017 and 2026, […]
Resident evictions from skilled nursing facilities (SNFs) are becoming a more prominent issue, as legal actions involving the matter make national headlines. The recent case of California resident Gloria Single, for example, is a clear illustration of what happens when a resident and the SNF where he/she resides become involved in a legal tangle over […]
Value-based programs can lead to lower costs of care and better quality of care for seniors enrolled in Medicare Advantage (MA) plans, according to an internal study from Louisville, Kentucky-based health insurance provider Humana. The study found total health care costs for practices in Humana’s value-based arrangements were 15% lower than original fee-for-service Medicare. Compared with standard […]
If current policies don’t change, federal spending on Medicare, Medicaid, and other health care programs will grow faster than any other category over the next three decades — eventually reaching 40% of the federal budget. The Congressional Budget Office (CBO) presented these statistics in a Wednesday presentation to the Council for Affordable Health Coverage and the American […]
A multi-year initiative from the Centers for Medicare & Medicaid Services (CMS) to lower hospitalizations in long-term care has its first set of finalized results, with data showing that the plan is working so far. CMS on Friday announced that all seven participating sites saw declines in hospitalizations. Six of the seven had statistically significant drops in […]
The Centers for Medicare & Medicaid Services (CMS) on Thursday announced an emergency suspension of Medicare quality reporting requirements for skilled nursing and other health care facilities affected by Hurricane Harvey. Skilled nursing facilities (SNFs) located in 32 Texas counties and five Louisiana parishes will be automatically granted exceptions for submitting Quality Reporting Program data […]
Total U.S. demand for skilled nursing care is significantly higher than previously projected, according to a new study from the RAND Corporation. While previous research studies have consistently found that about 35% of older Americans will spend at least one night at a nursing home during their lifetimes, mirroring data from the Department of Health […]
Last year, a federal judge ordered the Department of Health and Human Services (HHS) to clear a growing Medicare appeals backlog by 2021. But an appellate judge last week overturned the order, claiming that the lower court didn’t fully consider whether such a project would even be possible under current law. The U.S. Court of […]
For-profit skilled nursing operators captured a gradually larger share of the United States SNF market from 2009 and 2015, while non-profits increasingly ceded ground to governments. In 2015, for-profits accounted for 68.4% of the nation’s 15,583 certified nursing facilities, according to a Tuesday report from the Kaiser Family Foundation. That’s compared to a 23.8% share […]
At first, the conclusion seems obvious: Hospitals that sink more money into post-acute services provide better care to patients than their lower-spending counterparts. But those findings, released this week by researchers at the Massachusetts Institute of Technology, have stark implications for skilled nursing providers. “We find that patients who go to hospitals that rely more […]
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