More government scrutiny of Medicare Advantage (MA) plans and data sharing with nursing homes could reduce claims denials and burdens associated with such plans, sector leaders have long argued. And now a report released Thursday by a Congressional advisory body backs that view in shedding light on how enrollees are captured in data. The Medicare […]
The majority of MedPAC board members voted Thursday to recommend reducing Medicare-based payment rates for skilled nursing spending by 3% for 2025, despite voicing concerns about the federal minimum staffing proposed rule. MedPAC, which stands for the Medicare Payment Advisory Commission, is made up of health care professionals who make recommendations to Congress in terms […]
The Medicare Payment Advisory Commission (MedPAC) is recommending that for fiscal year 2025, Congress should reduce the 2024 Medicare-based payment rates for skilled nursing facilities (SNFs) by 3%, citing strong margin projections, occupancy growth and access to capital for the sector. “We project the SNF margins in 2024 to remain high even with the downward […]
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 […]
The Medicare Payment Advisory Commission (MedPAC) unanimously voted Thursday to approve its recommendation for a 3% Medicare payment cut for skilled nursing providers in 2024. This move follows the Commission’s draft recommendation discussed during a meeting on Dec. 9. Despite the proposal for a rate cut, MedPAC commissioners have noted that the industry is facing […]
With referrals to nursing homes under pressure, thanks to a bottleneck in part caused by the ongoing staffing crisis, hospitals are urging more support for post-acute providers. The American Hospital Association (AHA), for one, has called for “law updates” when it comes to hospital-based skilled nursing facilities and inpatient rehabilitation facilities (IRFs). AHA on Tuesday […]
As federal minimum staffing requirements loom for skilled nursing providers, analysts with the Medicare Payment Advisory Commission (MedPAC) unveiled crucial data detailing the effects of state-level standards on the industry. While research found state minimum staffing requirements increased staffing levels and in some cases improved quality measures, there were some unintended consequences: a decrease in […]
Home health agencies surpassed skilled nursing facilities as the most sought after post-acute care setting – SNF care went from most common to second-most used among Medicare beneficiaries, crossing paths with home health in February 2020 as the pandemic ramped up. By March 2020, the number of hospital discharges referred to SNFs dropped to 16.6% […]
The skilled nursing sector needs an overhaul in how facilities are paid – and how operators are allowed to allocate government dollars – in order to really live up to the term “nursing home.” That’s according to Harvard University professor David Grabowski, who — in referring to observations made by the late Robert Kane — […]
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 […]
After delaying cuts last year due to Covid, the Centers for Medicare & Medicaid Services (CMS) announced last week that it is moving forward with proposed cuts to Medicare funding for nursing homes. The CMS proposal includes a 3.9% Medicare rate increase for skilled nursing facilities, but the agency announced cutbacks to PDPM payments by […]
Capital providers dealing in the skilled nursing space are pushing back on the White House’s position on institutional capital, stressing the need for it in the sector. While institutional capital is critical to many of the key players in the space, some capital providers say newer owner-operators will have a hard time getting the necessary […]
While industry leaders have bashed many of the proposals laid out in the Biden administration’s nursing home reform package, improving public transparency of SNF ownership may be the White House’s best plan to curb who they see as “bad actors.” However, the details will be important to get right, with concerns about the impact that […]
While the Biden administration is seemingly trying to push private equity out of the skilled nursing sector, there seems to be growing confusion and frustration on how blaming such a small fraction of the overall sector is going to solve some of the challenges the industry currently faces. The skilled nursing market has been one […]
The value-based purchasing program (VBP) available to skilled nursing facilities, while garnering the attention of the Biden administration in its sweeping reform initiatives, was already under the microscope with federal agencies. The Centers for Medicare & Medicaid Services (CMS) already has been authorized to apply nine measures to the program in adherence with the Consolidated […]
The Medicare Payment Advisory Commission (MedPAC)’s value incentive program (VIP) seeks to standardize the many value-based purchasing programs that are available to different care settings, including skilled nursing. In its most recent report on Medicare payment policy, MedPAC devoted a chapter to the design of a VIP for post-acute care (PAC) in order to highlight […]
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, […]
For an industry where slim profit margins are a widely discussed concern, a federal advisory board found 2020’s robust 25% margin in Medicare payments justification for a suggested cut to base payment rates in fiscal year 2023. The Medicare Payment Advisory Commission (MedPAC) said “rebounded” industry transactions informed its recommended 5% cut as well, thanks […]
Nearly a decade after the Centers for Medicare & Medicaid Services (CMS) established accountable care organizations (ACOs) in conjunction with the Affordable Care Act, the health care landscape has shifted even further toward a focus on outcomes and value. As recently as October CMS and the Centers for Medicare & Medicaid Services Innovation Center (CMMI) […]
Although accountable care organizations (ACOs) have never been particularly popular among skilled nursing facilities, timing may be ripe to take on more risk to stay competitive in the market. ACO participation may help operators maintain referrals when so many potential residents are being diverted to home health care, hospice and other tracks along the continuum […]
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