Providers express support for MA prior authorization reform bill
By
Donna Shryer
Jun 16, 2024
Nursing home and senior living providers on Friday praised the newly introduced Improving Seniors’ Timely Access to Care Act, which would address the longstanding issue of prior authorization required...
A Medicare Advantage fix: What took so long?
By
James M. Berklan
Apr 12, 2024
Providers hoping that policy makers might some day show some backbone when dealing with Medicare Advantage plans can take heart. Well, at least a little.
Medicare Advantage plans forcing providers to take ‘optional’ payment reductions
By
Kimberly Marselas
Nov 15, 2022
Many skilled nursing providers are still underusing Interim Payment Assessments under the nascent Patient Drive Payment Model, but one new pressure is driving some to submit those extra patient evaluations...
A crazy way to spend a healthcare fortune
By
James M. Berklan
Dec 01, 2023
I’d like to announce that the folks who run Medicare Advantage plans will be shaking in their boots soon, fearful of what authorities are going to do to them.
Baseline proficiency for success with managed care payers
By
Susie Mix
Mar 11, 2024
Setting up a building with proficiencies in working with managed care payers is a key to success at this midpoint of the 2020s. Fifty-one percent of Medicare-eligible Americans are covered by Medicare...
Another week, more Medicare dis-Advantages
By
Kimberly Marselas
Aug 22, 2023
It’s starting to feel like every week brings another reason to begrudge Medicare Advantage plans their market-dominating growth.
Medicare Advantage: A not-so-advantageous deal for beneficiaries and providers
By
Brendan Williams
Nov 29, 2023
Open enrollment is well underway for Medicare, as television viewers inundated with cheesy insurance company ads can tell. Those ads must work. For the first time 2024 will see most Medicare...
Medicare Advantage set for regulatory showdown as penetration passes 50 percent
By
Kimberly Marselas
May 16, 2023
After years of explosive growth, Medicare Advantage crossed a major tipping point in January: More than 50% of all Medicare beneficiaries are now covered by an MA plan.
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.