CCRCs facing financial threats in their skilled care units, but there are silver linings: experts
By
Josh Henreckson
Feb 16, 2024
Facing the mounting financial challenges of providing skilled care on their campuses, continuing care retirement communities should carefully weigh a variety of tactics and the particularities of local...
Medicare Advantage slowing COVID discharges to SNFs: report
By
Kimberly Marselas
Sep 02, 2021
A new report finds Medicare Advantage restrictions are also creating log jams in hospitals desperate to discharge patients to post-acute care and free up needed beds.
‘Impossible’ Medicare Advantage denials decried during Senate hearing
By
Kimberly Marselas
May 18, 2023
A Senate subcommittee Wednesday sent letters to the nation’s largest Medicare Advantage insurers, demanding they reveal internal documents that illustrate how they make coverage determinations.
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...
CMS proposal offers long-awaited fix for Medicare Advantage appeals
By
Kimberly Marselas
Nov 08, 2023
Skilled nursing providers would get a new, improved appeals process for Medicare Advantage denials under a proposal issued late Monday by the Centers for Medicare & Medicaid Services.
Long-term care leaders cheer proposed Medicare Advantage appeals rule in final push
By
Josh Henreckson
Jan 08, 2024
A surge of public and professional support arrived Friday as the comment period closed for a proposed federal rule that providers say could level the playing field with Medicare Advantage plans.
Fogg clears the air on skilled nursing ‘tailwinds’
By
James M. Berklan
Oct 26, 2023
The headwinds for skilled nursing operators are significantly more numerous than the potential tailwinds, but there are reasons for provider optimism.
Reports forecast Medicare funding boost, dim overall outlook
By
McKnight's Staff
Apr 23, 2012
The Affordable Care Act will help Medicare save over $200 billion through 2016, according to government actuaries. But questions as to Medicare’s long-term solvency remain, another report from Social...
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...
Class action suit targets Medicare Advantage insurer’s use of AI to end rehab stays
By
Josh Henreckson
Dec 14, 2023
Two skilled nursing patients filed a class action suit against Humana Tuesday — alleging their Medicare Advantage benefits were cut prematurely short because of Humana’s wrongful reliance on artificial...