All quality nursing home providers should review available options for taking part in institutional special needs plans (I-SNPs), a Medicare Advantage insurance model, says the leader of the largest association representing skilled nursing providers.
“There are five or six different options out there,” Mark Parkinson, CEO and president of the American Health Care Association, told McKnight’s Long-Term Care News recently. “Any really good provider should take a look at what those options are.”
These opportunities run the gamut from being virtually risk-free, such as partnering with an established health services company such as Optum, which has an I-SNP plan and brings it into buildings. Another possibility is partnering with other providers to spread the risk. A third area is being a provider-owned I-SNP.
“You have to be relatively large because most people believe you need at least 1,000 enrollees,” he said, adding that even if a provider does its own plan there are gradations of risk.
He pointed out that I-SNPs, which allow for a medical doctor or nurse practitioner to care for residents in the plan on a routine basis, are not for every provider.
“The most important thing is I-SNPs will only work for those that achieve excellent clinical outcomes,” he stressed.
AHCA, which is still savoring the success of its first population health conference last December, is already tentatively planning to have a second conference this December.
Parkinson expects continued development of I-SNPs. Expansion will occur from two sources: those I-SNPs that have started and will grow their footprints, and the birth of new plans.
“As providers have heard about I-SNPs and the early success of the pioneers in the I-SNP world, more and more are making the decision to do it themselves,” he said. 2020 also will be the year to gather data on I-SNPs, he pointed out.
“It’s not a very mature product, but there are so many enrollees that came about in 2019 and 2020, that 2020 will be a great year to benchmark the clinical outcomes for residents in provider-owned I-SNPs and what the financial performance is for early adopters,” he said.
He was not hesitant to offer that he is bullish on the insurance model. The development of the I-SNP and population health management is “the most exciting in my entire career,” he said.
