Pandemic Encourages SNFs To Move To Private Rooms

There are many things payers are looking for when requesting a contract, private rooms being of them.

This article shows how the pandemic has encouraged skilled nursing facilities to move to private rooms and why it’s imperative to take advantage of the financial support the government is offering to renovate and remain competitive.

Occupancy Struggles For SNFs

A recent report showed that the national median occupancy for skilled nursing facilities is around 69% at the start of this year.

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Medicaid Managed Care Rule Changes

In November of this year, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to Medicaid managed care regulations that had been proposed two years prior.

Changes include updates to network adequacy standards, beneficiary protections, rates and payment.

For more on this, see the article below.

MA Capitation Rates Rising In 2022

An increase in capitated rates may prove positive for Medicare Advantage (MA) payers like Humana, UnitedHealthcare, Aetna and Anthem in 2022. To combat improper inflation of risk scores, the Centers for Medicare and Medicaid Services (CMS) is proposing to rely on encounter data to calculate patient risk.

For more on this, please see the article below.

I-SNPs Show Promise Even During Pandemic

An institutional special needs plan (I-SNP) is essentially where a nursing home becomes a Medicare Advantage (MA) provider. Many who are venturing into this process started last year. COVID-19, however, has delivered major challenges.

The article below details clinical upsides being discovered as well as a view of how timetables are currently adjusting.

Providers Who Perform Well Under PDPM

Under the new Patient-Driven Payment Model (PDPM), Medicare rates are determined by a formula that captures how providers measure on five care components.

Those that are performing well under PDPM are effectively capturing key payment drivers and not leaving money on the table.

For more on this, please see the article below.