Low occupancy. Low profit margins. Impossibly low reimbursements. Pressure to risk share. Inaccurate staffing tabulations.

As the president and CEO of the nation’s largest association of nursing home operators, Mark Parkinson clearly has a lot on his mind these days, including the problems listed above.

But it hasn’t stopped him from prognosticating on the future. He recently predicted that the next 10 to 15 years might eventually be viewed as a time when successful providers took control of their own fate.

The phrase that pays is “population management.” It’s a new point of emphasis and long-term care providers are going to be hearing a lot about it. In brief, it means operators taking control of their future by creating their own managed care companies for their residents.

The opportunity lies with Institutional Special Needs Plans, or “I-SNPs” in the industry vernacular. Some 22 skilled nursing providers have already created their own Medicare Advantage managed care companies through I-SNPs.

Many could be active in a newly formed council by the American Health Care Association/National Center for Assisted Living. The new workgroup met for the first time in January to discuss best practices so others can look into starting down the same path.

There is no single trait that automatically validates a company for an I-SNP. But regional firms, including the likes of Marquis Companies in the Northwest and NHS Management in the Southeast, are well represented. Former AHCA Board Chair Tom Coble and his Oklahoma-based Elmbrook Management Company were the first to form an I-SNP.

“If we’re not a part of the managed care world, we’re just commodities,” Parkinson warns. 

So just as post-acute providers discovered how to take advantage of rehab and therapy dollars over the past two decades, Parkinson thinks they’ll rally to control their own fate once again.

“I applaud the 22 groups that have formed their own companies,” he said. “We want to make sure others can do it, too.”

He’s not ready to say everybody has to be in an I-SNP to find success in the future. But no matter the size of the provider, it must at least investigate its options. For some, partnering with others who are taking the full plunge would make the most sense.