Skilled Nursing News June 14, 2024
Operators have been opting for different payer sources other than Medicare Advantage plans given its persistent challenges.
Medicare Advantage’s lower reimbursement rates compared to traditional Medicare and higher administrative burdens tied to prior authorizations and payment denials, have caused operators to seek even Medicaid as an alternative payer, emboldening efforts by advocacy groups to push for a rate floor for Medicare Advantage plans.
For providers with decent Medicaid rates, it might make sense to add more Medicaid beneficiaries to combat low MA reimbursement, said Chris Chirumbolo, CEO of Ohio-based Carespring Health Care Management. Such a shift could also affect staff morale.
“This shift has been further driven by Medicare Advantage plans keeping rates stagnant for long periods of time and...
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