The move to managed care from fee-for-service has been “pretty much a disaster” for long-term care, said Mark Parkinson, president and CEO of the American Health Care Association. 

Managed care and accountable care organizations have led to a reduction in average length of stay and payments, he said at a December AHCA conference.

One solution for long-term care during this volatile period has been to join or create institutional special needs plans, or I-SNPs, he said. These insurance models allow nursing homes to provide a higher level of care and control the disbursement of funds.