Nursing Facilities Need to Weather the ‘Reimbursement Storm’ of Medicare Advantage

Ken BellSkilled NursingLeave a Comment

With Medicare Advantage revenue “significantly lower” than fee-for-service reimbursement, a new Zimmet Healthcare Services Group analysis says, skilled nursing facilities need to weather today’s “reimbursement storm” in order to make it to the incoming wave of baby boomers that will need facility services.

In the meantime, Zimmet suggests operators utilize facility data to improve MA performance.

“Most MA claims were submitted by SNFs with at least a three-star rating, but in areas with less bed-saturation, two-stars were not uncommon,” the report said. “There was no correlation between 5-Star rating and episodic revenue, while the 30-day hospital readmission rate explained less than 20% of payment variation.”

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