Some Managed Care Plans Lift Restrictions on Skilled Nursing Coverage Amid COVID-19 — But Not All

Multiple managed care plans have made changes to their procedures for admissions to the skilled nursing setting amid the ongoing coronavirus pandemic, with several major companies suspending prior authorization requirements for admissions to a skilled nursing facility. The changes, however, are not uniform — and that’s if the managed care organization (MCO) chooses to make […]

New Skilled Nursing Payment Model Raises Medicare Advantage Questions

Providers that have learned to navigate the Medicare Advantage ecosystem will likely have a leg up when approaching the new payment model for skilled nursing facilities, but many questions still remain about how managed care plans will adapt under the coming system. The Patient-Driven Payment Model (PDPM) reflects an ongoing push toward rewarding therapy providers […]

Despite Recent Research, SNF Quality Key for Medicare Advantage Plans

As Medicare Advantage (MA) continues to capture market share, skilled nursing facilities can seize the moment by focusing on quality to draw the attention of MA providers. The MA plans themselves are starting to pay more attention to quality, compared with prior years when geography and SNF-hospital partnerships took precedence, Mary Hsieh, managing principal at […]