How Saber’s I-SNP Partnership with Optum Gave the Operator a Head Start on COVID-19

In the era before COVID-19, specialty in-house Medicare Advantage plans had emerged as one of the hottest topics in long-term care — control the payer source, the thinking went, and an operator could eliminate the financial uncertainty and pressure that comes when working with managed care plans. But with a global pandemic running rampant through […]

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 […]

UnitedHealth’s I-SNPs Reduced Readmissions, Emergency Visits While Boosting Skilled Nursing Use

In-house Medicare Advantage plans have emerged as a hot trend in the skilled nursing space, as operators look for ways to take control over their reimbursement destiny — and a new study shows that the model could have real benefits for both patients and Medicare at large. Members enrolled in insurance giant UnitedHealthcare’s Institutional Special […]

Editor’s Take: Skilled Nursing Industry Can Ignore Medicare Advantage at its Own Risk

Every industry gathering has a theme, whether it’s an intentional move by the organizers or not. But the most illustrative conference experiences come when attendees and those in charge both can’t stop talking about the same subject — as was the case this past week at the National Investment Center for Seniors Housing & Care’s […]

What Hospitals Want: How SNFs Can Break into New Payment Partnerships

Skilled nursing facility operators frequently hear about how forging hospital partnerships is essential to their success under new payment models, but the intricacies of those interactions can often be difficult to navigate. Speaking at the National Investment Center for Seniors Housing & Care (NIC) spring conference in San Diego last week, the leader of one […]

Observation Stays Save Money for Private Insurers, Patients

Observation stays at hospitals have been controversial in the long-term care world for their role in Medicare reimbursements, but a new study shows that they could save money on the private-pay side — a trend that could have consequences for both types of insurance models. Between 2009 and 2013, non-elderly patients affiliated with three major […]