McKnight's Podcast

McKnight's Long Term Care, Newsmakers - ‘You can’t even run any more’: How to stand tall amid Medicare Advantage’s relentless drive into skilled nursing

Episode Notes

Time was, not too long ago, that some skilled nursing facilities refused to contract with Medicare Advantage plans, knowing their rates typically came in far below those for traditional Medicare patients.

That time is over, says Susie Mix, a consultant who has spent more than two decades helping providers navigate the ever-changing world of managed care contracts.

“There isn’t a viable way to be successful running a skilled nursing facility without working with the managed care plans in your area,” Mix tells McKnight’s Long-Term Care News in this episode hosted by Senior Editor Kimberly Marselas.

Even though nursing homes continue to accept more medically complex patients — a factor that, logically, should move payment upward — a recent report shows average Medicare Advantage payments per patient day actually continue to fall. And Medicare Advantage plans now cover close to half of all Medicare beneficiaries.

But that doesn’t mean providers are helpless. Mix offers insights on the latest operational and financial challenges and expected regulatory changes, while also providing actionable tips on negotiating more favorable Medicare Advantage contracts.


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