Medicare eligibility comes with increase in tooth loss, Harvard study reveals
By
Alicia Lasek
Feb 10, 2023
When patients become eligible for Medicare coverage, restorative dental care immediately falls and tooth loss increases, a new study from Harvard University and Brigham and Women’s Hospital has found.
Flurry of Medicare Advantage regulation likely to hit nursing home coffers
By
Kimberly Marselas
Feb 03, 2023
Federal efforts to rein in Medicare Advantage spending and recoup payments awarded for improper diagnoses will likely lead to even more financial pressure on nursing homes that serve plan beneficiaries,...
CMS completes minimum staffing study; targeting ‘onerous’ MA authorizations
By
Kimberly Marselas
Jan 25, 2023
Two proposed rules should help patients improve their Medicare Advantage plan selections while standardizing expectations for skilled nursing and other healthcare providers, federal officials reiterated...
As Medicare Advantage threats mount, providers seek better partners: 2023 Outlook Survey
By
Kimberly Marselas
Jan 06, 2023
More skilled nursing providers are embracing Institutional Special Needs Plans by joining existing programs or creating their own as enrollment in other Medicare Advantage plans surpass half of all Medicare...
Projected Medicare Advantage growth to bring more provider headaches, more congressional scrutiny
By
Joe Bush
Oct 05, 2022
Several large insurance providers are expanding their Medicare Advantage plans to new states and hundreds more counties, effective in 2023, adding pressure on skilled nursing operators as enrollment booms.
‘Death spiral’ for SNFs as Medicare Advantage pay decreases
By
Kimberly Marselas
Sep 06, 2022
Pressure to accept low-ball contracts with Medicare Advantage plans that continue to reduce reimbursement is driving some skilled nursing providers into “a death spiral,” a major aging services association...
House committee approves bill that would reform prior authorization under Medicare Advantage program
By
Danielle Brown
Jul 29, 2022
Providers demanding change to the Medicare Advantage program may soon get their wish after a House panel advanced a measure that would reform the program’s prior authorization process.
MA enrollees with dementia report poor quality of care: study
By
Alicia Lasek (f3)
May 09, 2022
Medicare Advantage plans will be more incentivized to address gaps in care if consumer care assessments include more input from enrollees with dementia, investigators say.
Providers demand fixes after feds find MA plans wrongly delay or deny SNF services too often
By
Danielle Brown
May 02, 2022
Skilled nursing providers are demanding changes after a new federal report found that Medicare Advantage organizations (MAOs) have improperly denied or delayed services to beneficiaries to increase profits.
8.5% payment boost to Medicare Advantage plans ‘clear signal of support’ from CMS: expert
By
Danielle Brown
Apr 06, 2022
The 8.5% boost in average revenue slated for Medicare Advantage plans in 2023 is proof of the Centers for Medicare & Medicaid Services support of the program and could mean improved payment for post-acute...