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 […]
MedPAC
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 […]
The value-based purchasing (VBP) program for skilled nursing facilities was implemented in 2018 as part of the 2014 Protecting Access to Medicare Act – and three years later, the program is showing “fundamental design flaws” so significant that eliminating and replacing it is the only option. That’s according to the Medicare Payment Advisory Commission’s (MedPAC) […]
The top federal Medicare advisory body this week formally recommended against raising rates to skilled nursing facilities in fiscal 2022, arguing that the sector will eventually recover from COVID-era financial strains. “While the projected level of payments indicates that payments need to be reduced to more closely align aggregate payments and costs, the lasting impacts […]
The federal government’s sole attempt at linking nursing home Medicare reimbursements with outcomes is broken and requires an overhaul, the Medicare Payment Advisory Commission (MedPAC) determined. The Skilled Nursing Facility Value-Based Payment (SNF VBP) Model has rewarded strikingly few facilities while the majority have lost money — though the amounts involved in either direction were […]
The average total margin for freestanding nursing homes dropped to -0.3% in 2018, according to a new report from the Medicare Payment Advisory Commission (MedPAC) — the first time that group found a negative overall margin since 1999. That said, Medicare revenue remained relatively strong in 2018, the most recent year for which data was […]
Early research into the impact of COVID-19 on seniors — both among the general population, and in nursing homes — has revealed endemic connections among race, income, and the likelihood of infection and death. Those patterns, reinforced by a new set of data probing COVID-19’s impact on Medicare beneficiaries, should prompt a more rapid move […]
A sweeping ban on nursing home visits dominated headlines both inside and outside the industry over the weekend, but buried in the federal government’s recent emergency COVID-19 guidelines was a waiver of the three-day hospital stay rule for Medicare skilled nursing coverage. Under normal conditions, a Medicare beneficiary must remain in the hospital for three […]
The gulf between self-reported and payroll-based staffing records for nursing homes continues to widen, with a new study showing a reality that vastly differs from government expectations. The amount of registered nurse (RN) coverage falls well below the standards set by the Centers for Medicare & Medicaid Services for most skilled nursing facilities in the […]
Accountable care organizations (ACOs) have generated a slight reduction in overall Medicare spending, a new analysis found — adding another viewpoint to a growing and occasionally contradictory body of research. The Medicare Payment Advisory Commission (MedPAC) determined that ACOs led to a 1 to 2 percentage-point drop in Medicare outlays between 2013 and 2016, though […]
A top government watchdog and advocate for Medicare payment reform on Friday accused post-acute care providers of using mandatory functional assessments to boost payments instead of accurately recording patient needs. As part of its sprawling annual report to Congress on reimbursement issues, the Medicare Payment Advisory Commission (MedPAC) probed the differences between individual residents’ functional […]
The Medicare Payment Advisory Commission (MedPAC) on Friday again called for up to $2 billion in cuts to skilled nursing reimbursements under Medicare — but with a caveat that the new payment model could cause significant changes for operators moving forward. The nation’s more than 15,000 skilled nursing facilities should not receive a scheduled 2.6% […]
Skilled nursing providers actually saw across-the-board gains in Medicare margins between 2016 and 2017, but the effects were mitigated by a familiar foe: Medicare Advantage plans. The average provider saw a profit of $102 per patient day for residents covered under Medicare Part A in 2017, according to a new analysis from accounting and advisory […]
After floating a proposed recommendation to slash nursing homes’ Medicare reimbursements for fiscal 2020, a leading legislative voice on health care issues made it final last week. The Medicare Payment Advisory Commission (MedPAC) called on Congress to reduce funding for skilled nursing facilities by up to $2 billion in the next fiscal year, citing sufficient […]
As referral networks narrow and skilled nursing providers feel increased pressure to prove their worth to hospitals and doctors, one government agency says residents still frequently miss the highest-quality options in their own areas. In its most recent report to Congress, the Medicare Payment Advisory Commission (MedPAC) asserts that many hospitals discharge post-acute care patients […]
The Medicare Payment Advisory Commission (MedPAC) issued a mostly positive assessment of the new proposed payment rules for skilled nursing facilities, but the organization wants change to come faster than planned. Citing the similarity between the new Patient-Driven Payment Model (PDPM) and the now-shelved Resident Classification System, Version I (RCS-I), MedPAC asserted that the planned […]
Lost in a flurry of news from the National Investment Centers for Seniors Housing & Care (NIC) Spring Investment Forum and harsh funding recommendations from MedPAC, here are some of the stories we couldn’t cover earlier in the week to help get you ready for the one ahead. Mainstreet hits another snag A week after […]
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