More Scrutiny on Medicare Advantage Data Collection: MedPAC Report Dives into Encounter Data

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 […]

As a ‘Better Advisor’ to Congress, MedPAC Mulls CMS Staffing Mandate Effects But Proposes 3% Medicare Cut

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 […]

MedPAC Advises Cutting Skilled Nursing Medicare Payment Rate by 3%

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 […]

MedPAC Unanimously Approves 3% Proposed Medicare Cut for Skilled Nursing

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 […]

Hospital Association to MedPAC: SNF Payment Reduction Harmful to ‘Entire Care Continuum’

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 […]

‘Powerful Data’ Could Inform CMS’ Nursing Home Minimum Staffing Standards

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 Surpassed SNF Use in 2020 Among Medicare Beneficiaries

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% […]

Why Nursing Homes Shouldn’t Expect Delayed or Phased-In CMS Medicare Cuts

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 […]

White House Throws Its Weight Behind SNF Value-Based Purchasing Expansion, with Staffing Measures Targeted

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 […]

Streamlined Value Incentive Program Matches CMS Desire to Consolidate Value-Based Care

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 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, […]

MedPAC Calls For 5% in Skilled Nursing Cuts

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 […]

Pandemic May Have Been ‘Ultimate Stress Test’ for I-SNP Success in Nursing Homes

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) […]

ACO Participation May Keep SNFs ‘In the Game’

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 […]