Eighty-five percent. Of the roughly 130,000 people enrolled nationwide in institutional special needs plans, or I-SNPs, about 85% reside in nursing homes. That represents approximately 12% of the total nursing home population. And it represents a major opportunity for skilled care providers. Skilled nursing facilities operate in a financially constrained environment. At the same time, […]
When the nursing team at the Chesterfield, Missouri-based Delmar Gardens West needed to leverage proactive insights to optimize system-wide health outcomes, they streamlined the process and chose the one, right tool: a human. “Everyone here who has Optum can’t wait to see Sarah every day,” says one Delmar Gardens patient. “She’s just wonderful.” This is […]
Amid rising patient acuity, Optum’s value-based care (VBC) initiatives and more active, data-driven clinical management – particularly around hospital discharge and care transitions – have reduced admissions to nursing homes. “We’re already seeing inpatient skilled nursing admissions trending sharply below historical levels, including an approximately 35% reduction in skilled nursing admissions in the first month […]
The number of Medicare Advantage Institutional Special Needs Plans (I-SNPs) is down 5% for plan year 2026, but the number of I-SNPs led by a provider organization is up. This was one finding from an ATI Advisory analysis of Medicare Advantage (MA) plan offerings, which were the topic of an Oct. 1 webinar. Despite the […]
Leadership changes within insurance giant UnitedHealth Group (NYSE: UHG) and its subsidiary Optum have rattled the company from the inside out, with UHG CEO Andrew Witty abruptly resigning on Tuesday, replaced with Chairman Stephen Hemsley who was CEO for UnitedHealth prior to stepping down in 2017. The news comes on the heels of new leadership […]
As the Medicare Advantage (MA) program has continued to grow over the last decade, so too have Institutional-Special Needs Plans (I-SNPs) for care rendered in nursing homes or other long-term care settings. However, there may be slight shrinkage in store for these plans in 2025. According to a KFF analysis of CMS Landscape files, I-SNPs […]
Optum is scaling back its Medicare Advantage Special Needs Plans for nursing home and assisted living residents in several regions. The health care services arm of insurance giant UnitedHealth Group (NYSE: UHG), Optum, made headlines earlier this year for workforce cuts. Now, the company is shutting down Institutional Special Needs Plans (I-SNPs) in several states, […]
Optum is paring back its workforce, including in the parts of the business related to Medicare Advantage plans for nursing home and assisted living residents. This is according to multiple industry sources who communicated with Skilled Nursing News, as well as anonymous posts on an online message board related to the layoffs at Optum, which […]
For most nursing home residents, the time they spend in the skilled nursing facility falls at the end of their lives. This time is usually filled with stress, uncertainty and frustration. Skilled nursing providers have the job of giving patients the care they need along with the even greater role and responsibility to prioritize patients’ […]
As nursing home organizations adjust to a changing environment of reimbursement, Medicare Advantage Institutional Special Needs Plans (I-SNPs) are undergoing rapid growth, with operators pursuing distinct strategies meant to realize financial and operational gains. The benefits of an I-SNP can range from more control over quality, happier clinical staff, reduced administrative burdens, improved compensation and […]
Optum, the diversified care delivery arm of UnitedHealth Group (NYSE: UNH), has reached an agreement to acquire home health giant Amedisys (Nasdaq: AMED), which provides skilled nursing facility-at-home services via Contessa Health. Optum emerged as a suitor for Amedisys earlier this month, after the home health giant had previously announced a deal to combine with […]
This article is sponsored by Optum. This article is based on a discussion with Michelle Graham, director of Clinical Pharmacy Patient Care for Optum Home and Community. The conversation took place on April 20, 2023 during the Skilled Nursing News Clinical Conference. The article below has been edited for length and clarity. Skilled Nursing News: […]
More than half of nursing home residents suffer from chronic pain1, yet multiple studies indicate it remains largely undertreated2. The reasons are multifactorial and complex. Challenges include: identifying if residents are experiencing pain, identifying the source and severity of pain and identifying the risks and benefits associated with the use of many medications used in […]
Before David Dunn joined Shannon Gray Rehabilitation & Recovery Center, he’d never worked in a senior community that used an institutional special needs plan, or I-SNP, to deliver extra levels of personalized care to residents suffering from complex and chronic conditions. Now, after 10 years of working in partnership with the Optum care model, he […]
Falls are the leading cause of injuries in older adults, and experts say soaring rates of fall-related death and injuries are one of most significant health issues facing today’s aging society. From 2007 to 2016, fall death rates in the United States increased 31%, according to the Centers for Disease Control and Prevention (CDC). And […]
Finding and retaining workers is one of the biggest challenges facing skilled nursing communities today. And the longer the staffing crisis drags on, the broader the impact will be on the most important piece of the whole equation: residents. The human touch is a key element of senior care, but one that can suffer when […]
The nurse practitioner (NP) role has evolved to be much more involved in the day-to-day operations of a nursing home, especially given the higher acuity that the care setting has adopted. Institutional special needs plans (I-SNPs), which are designed to care for residents that need a higher level of clinical care, has led to more […]
This article is sponsored by Optum. This article is based on a Q&A discussion that took place during the Clinical Conference with Terry Wihlen, Vice President of Clinical Operations in Senior Community Care at Optum. The Q&A took place on May 5, 2022. The discussion has been edited for length and clarity. Skilled Nursing News: […]
CVS Health (NYSE: CVS) appears poised to become a bigger player in the post-acute care space moving forward, in a pilot program that highlights ongoing shifts away from facility-based care and into the home. The company announced last week that it is preparing to launch a post-acute transitions pilot for Aetna members in select geographies […]
Former ProMedica Senior Care President David Parker took on a new role at Optum this summer, putting his 30-plus years in skilled nursing executive leadership to good use as vice president of strategy for its complex care management division. Optum is the care delivery arm of UnitedHealth Group, and has offered value-based care plans for […]
