New ACO Model Targets High-Cost Senior Care Population

Some of the sickest—and most costly—residents in senior care settings are the focus of a new type of accountable care organization (ACO).  A new ACO is in the works for dual-eligible Medicaid-Medicare beneficiaries, the Centers for Medicare & Medicaid Services (CMS) announced Thursday. These beneficiaries—who typically are very frail, sick, and old—account for a disproportionate […]

MedPAC Calls for 4% SNF Medicare Cuts, Home Health Incentives

As Medicare margins continue their double-digit residency for skilled nursing facilities (SNFs), the Medicare Payment Advisory Commission (MedPAC) is recommending that Congress mandate a 4% payment reduction to providers starting in 2015, among other policy changes within the post-acute care space.  Despite recent reductions to SNF payments, Medicare margins remained high in 2012 at 13.8%, according […]

Can Good Senior Care Coordination Happen Under Current Medicare Payment Model?

The way care is delivered and paid for under the Medicare system is in desperate need of restructuring in order to achieve good care coordination, but that might only happen if life under the current fee-for-service model gets “more difficult” for healthcare providers, said the chairman of the Medicare Payment Advisory Commission (MedPAC) in a June […]

Should Medicare Payments Subsidize Medicaid Residents?

Roughly two-thirds of nursing home residents rely on Medicaid to fund their stays, according to the Centers for Medicare & Medicaid Services (CMS), but oftentimes Medicaid reimbursements to nursing homes don’t fully cover costs of care, and many operators seek to bridge the gap with Medicare reimbursements. While many industry representatives believe Medicare payments should […]

Skilled Nursing Medicare Margins “High” at 14%, MedPAC Says to Freeze Payment Updates

Higher Medicare margins in certain types of skilled nursing facilities has prompted the Medicare Payment Advisory Commission (MedPAC) in its March 2012 report to Congress to freeze payment updates in 2013 and rebases the prospective payment system (PPS) to more closely match facilities’ costs of care. Based on estimates of the changes in revenues and […]