As the skilled nursing industry shifts towards managed care plans like Medicare Advantage and Medicaid managed care, “conveners” have become essential in managing care for specific patient populations, especially for long-term care residents and dual-eligible individuals. And while conveners have helped nursing homes and health care providers adapt to the changing landscape and achieve better […]
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 […]
As skilled nursing facilities across the country locked down to try to curb the spread of COVID-19, try to stay on top of constantly changing guidance from both the state and federal level, and navigate new mandates to report COVID-19 cases, it might be easy for them to overlook reaching out to insurers working as […]
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 […]
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 […]
With managed plans gobbling up an increasing share of Medicare enrollees, skilled nursing executives need to gain fluency in the language of insurance providers — or risk being left behind. That was the message from a recent panel discussion at the National Investment Center for Seniors Housing & Care (NIC) Spring Investment Forum in Dallas, […]
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 […]
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