WASHINGTON, DC — Changing payment models have made the last decade “an incredibly bad time” for long-term care in many ways, the leader of the nation’s largest nursing home group said Monday. Mark Parkinson, the president and CEO of the American Health Care Association, made the damning assessment during opening remarks at AHCA’s inaugural population health summit.
Over the last 10 years, the change has been “seismic,” he noted, pointing out that in 2010, over 70% of post-acute volume was fee-for-service and 25% was managed care. Now, fee-for-service represents less than 50% of post-acute volume, and managed care and accountable care organizations occupy the rest.
Managed care and ACOs have dramatically reduced SNFs’ average length of stay, as well as payments. The end result has been severe reductions in SNF margins. “For the sector, it’s been pretty much a disaster,” Parkinson said.
He spoke on the opening day of the Population Health Management Summit for Long-Term and Post-Acute Care Leaders, which is being held at the InterContinental Washington, D.C. – The Wharf. Around 225 attendees are at the conference, which ends today.
A major focus of the conference is the relatively new but increasingly popular Medicare Advantage payment models called SNPs (special needs plans). Many SNFs are engaged in I-SNPs (institutional special needs plans) in particular. In 2018, there were 98 I-SNPs and 81,730 enrollees. In early 2019, the number of I-SNPs had grown to 126 and there were 94,980 enrollees, pointed out Dan Mendelson, founder of Avalere Health.
To help address such ongoing growth, AHCA developed the Population Health Management Council, which kicked off in January and led to this week’s conference.
Signs indicate that I-SNPs could represent a positive development for the sector, Parkinson said. Nothing he has seen during his experience in long-term care better “aligns our interests with the interests of the residents we take care of,” he said.
