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...
An insider’s guide to managed care contract exclusions
By
Susie Mix
Dec 18, 2023
There’s a key question more providers need to know the answer to: What is a contract exclusion? A contract exclusion details the medications and treatments that are not included in the levels of a managed...
Staff shortages — what’s the opportunity?
By
Susie Mix
Oct 18, 2023
Amid some good news in healthcare hiring as we recover from the pandemic, staff shortages involve a range of difficult challenges that will persist for years. Among other factors, it’s difficult to find...
Insurgence of leveled contracts
By
Susie Mix
Jul 14, 2023
By now, we’re all pretty familiar with the fact that managed care is altering the post-acute care payor mix with Medicare Advantage plans. This is a byproduct of national policy, intended to offset our...
Yo, I’ll tell you what I want, what I really, really want
By
Steven Littlehale
Oct 14, 2022
It’s a curious day when I lift a lyric from the Spice Girls to title an article. The Spice Girls’ first single, “Wannabe,” was released in 1996 and rocketed to the top of the British singles chart....
America’s nursing homes at a crossroads
By
Scott Rifkin, MD
Aug 24, 2022
America’s nursing homes are at a crossroads. Operators are challenged by a history of insufficient funding under the Medicaid program and eroding Medicare payments. Coupled with long-term care facilities...
Oil, gold, nursing homes? Stop acting like you’re a commodity
By
Kimberly Marselas
Jun 11, 2021
With all the talk of impending acquisitions this spring, it’s hard not to think of skilled nursing facilities as commodities to be bandied about for the right price — or shuttered if they don’t produce...
CMS let the cat out of the bag, but it’s managed care that’s ready to pounce
By
Kimberly Marselas
May 05, 2021
If you work with managed care (and who doesn’t anymore), chances are pretty good you’re already on a collision course that’s been accelerated lately
The beauty of offering a full-service managed care platform
By
Franklin Segura
Jul 22, 2019
We do not turn away difficult or specialty patients because we can handle almost any specialty pertaining to the senior patient.
Block grants won’t lead to cost-cutting efficiency
By
Brendan Williams
May 31, 2019
Eviscerating the social safety net through block grants can only further contribute to a dystopian future for aging adults and all others on Medicaid.