CMS eyes 8% revenue increase for Medicare Advantage
By
Danielle Brown
Feb 04, 2022
The Centers for Medicare & Medicaid Services is forecasting a nearly 8% increase in revenue for Medicare Advantage plans next year. The agency released its 2023 advance notice earlier this week.
Demand for I-SNP coverage drives Longevity’s growth
By
Kimberly Marselas
Jan 17, 2022
Explosive growth for Longevity Health Plan’s I-SNPs underscores skilled nursing providers’ increasing willingness to partner for patient care, especially if partners add clinical capabilities and...
With managed care poised to ‘explode,’ operators try to grasp control with alternatives
By
Kimberly Marselas
Jan 07, 2022
Providers struggling with everyday expenses and reimbursement rates that have largely failed to keep up with the costs of care plan to pursue a broad range of new revenue streams this year. That’s according...
Analysts break ground with first batch of SNF Medicare Advantage data
By
James M. Berklan
Oct 11, 2021
Managed care plans typically hold all the cards when it comes to rate-setting. But a new way of analyzing billing data could finally give increasingly leveraged providers a better leg to stand on, financial...
When one dangerous compromise leads to another
By
James M. Berklan
Jun 28, 2021
Sometimes providers are backed into a corner and must do non-preferred things. But the big question becomes what’s the next step after the first concession?
As Medicare Advantage drives rate lower, fed-up CEOs embrace strategies that limit carriers’ influence
By
Kimberly Marselas
Apr 26, 2021
Medicare Advantage’s aggressive market penetration represents a major threat to skilled nursing providers, some of whom now find themselves clearing less per resident day through MA plans than they do...
CMS rule changes aim to increase telehealth access for Medicare Advantage beneficiaries
By
Danielle Brown
May 26, 2020
Changes under a recent final rule encourage Medicare Advantage plans to increase their telehealth benefits and plan options for beneficiaries in rural areas.
Operators treating Medicare Advantage enrollees for depression, dementia and frailty are unfairly penalized:...
By
Danielle Brown
Feb 11, 2020
Operators who serve a disproportionate share of beneficiaries with these conditions are penalized twice, argue researchers.
CMS announces new ‘innovations’ to Medicare Advantage plans
By
Marty Stempniak
Jan 22, 2019
The federal government announced a broad array of changes to Medicare Advantage plans last week in hopes it will further pressure providers to up their game in caring for seniors.
Justice Department investigating Humana billing practices
By
John Hall
Feb 24, 2015
Humana Inc. reports that it is cooperating with a Department of Justice inquiry into whether it exaggerated the severity of elderly patients’ illnesses to generate higher Medicare reimbursements.