AI Use by Medicare Advantage Blamed for Increased Denial of Nursing Home Services

Over-reliance on artificial intelligence is compromising post-acute care for nursing home residents on Medicare Advantage plans. This view of the problematic use of algorithms for prior authorizations – and denial based on incorrect assessment of patient needs – is at the center of reporting and analysis published in the health, medicine and life sciences publication, […]

Future Leader: Gina Bruno, Vice President of Value-Based Care, naviHeath

The Future Leaders Awards program is brought to you in partnership with PointClickCare. The program is designed to recognize up-and-coming industry members who are shaping the next decade of care delivery across the senior housing, skilled nursing, home health and hospice industries. To see this year’s future leaders, visit Future Leaders online. Gina Bruno, vice […]

At Every Stage of COVID-19 Spread, Nursing Homes Face Difficult Cohorting Decisions

At too many nursing facilities across the country, COVID-19 has already swept through the resident population with deadly efficiency. But others remain untouched by the novel coronavirus, and in some cases, facilities are beginning to discharge former COVID-19 patients back into the community. No matter where a given facility may be along the COVID-19 trajectory, […]

When Hospitals Build Skilled Nursing Networks, How Narrow is Too Narrow?

Skilled nursing providers have faced pressure to break into area hospitals’ top-tier referral groups — the increasingly select few deemed fit to manage acute care operators’ patient populations across the continuum. But when SNFs size up their competitors in their marketplaces, are they facing off for a slot in a hospital’s top five, or top […]

Uncertainty Surrounds New ‘Arbitrary’ Skilled Nursing Payment Rules

Early reactions to the finalized skilled nursing payment rules from the Centers for Medicare & Medicaid Services (CMS) are in, with one leading provider group issuing a stark warning about the days ahead. “While the skilled nursing profession welcomes a new payment model, we are concerned with the language in this rule about the Patient-Driven […]

New Skilled Nursing Payment Plan Shows CMS Listened to Providers

The Centers for Medicare & Medicaid Services (CMS) shook the skilled nursing world last week by rolling out a proposal for a new payment model, replacing the structure that the industry had been anticipating for a year. But several experts say that operators should look at the changes as positive updates made with providers in […]

SNFs’ Place in New Bundled Payment Model Unclear

The skilled nursing industry is still sorting out how it will participate in a newly announced bundled payment model rolled out by the Centers for Medicare & Medicaid Services on Tuesday. Early analysis of the text from CMS seems to exclude skilled nursing facilities, home health agencies and other post-acute care providers from applying for […]