[On-demand] Managed Care Madness: Data strategies for SNF Medicare Advantage success

Ken BellClient News, Skilled Nursing, Training2 Comments

Strategies to help you WIN with Medicare Advantage

Medicare Advantage (MA) has overtaken traditional Fee-for-Service (FFS) by volume of beneficiaries – and it’s causing a serious problem for providers. MA is expected to drain $14 billion from Skilled Nursing Facility (SNF) revenue in 2024.  Providers are optimistic that MA plans will be forced to cover more SNF days going forward, but the price per day keeps falling. MA plans want reduced utilization and lower costs, so it's in their best interests to reward efficient providers. But it's difficult to negotiate rate increases with MA plans because there is no data to benchmark your performance against!

With empty beds and no comparative data measuring outcomes and costs, MA plans continue to drive down SNF payment rates. In this webinar, you will learn how to access MA utilization data from thousands of providers and measure your value proposition in clear terms: outcomes, length of stay, per diem rates, and more. Learn essential strategies as MA plans continue to grow in long-term care.

This webinar will help you:

  1. Benchmark Medicare Advantage utilization, payment, and outcomes against peer group providers.
  2. Quantify your SNF’s value proposition to insurers.
  3. Identify opportunities to support rate increases.
  4. Understand how ISNP ties into short-term MA utilization.
  5. Measure ancillary spending per admission.

Intended audience: Case management directors, Reimbursement VPs and directors, MCO contract specialists, C-Suite (CFOs, CEOs, COOs, Chief Strategy Officers)

[Webinar] Managed Care Madness

Data strategies for SNF Medicare Advantage success

Click here to access the recording and slides

About your experts

Marc Zimmet
President & CEO — Zimmet Healthcare Services Group, LLC

Marc Zimmet is CEO of Zimmet Healthcare Services Group, LLC and its related group of entities.  Marc entered the skilled nursing industry in 1993, beginning his career preparing Medicare cost reports and appeals.  His firm now services a diverse client base approaching 4,000 post-acute care providers and industry stakeholders on matters relating to reimbursement-regulatory compliance, data analytics, quality improvement, strategic planning and market reform.  Marc is an active member of many industry associations and serves on the Board of several healthcare provider, insurance and support companies.

Vincent Fedele
Partner — Zimmet Healthcare Services Group, LLC
Chief Operating Officer — z.PAX, the Post Acute eXchange

Vincent Fedele is a Partner at Zimmet Healthcare Services Group, LLC and the Chief Operating Officer of z.PAX, the Post-Acute eXchange.  He is responsible for strategic product direction and leads the consulting firm’s data analytics department.  Vincent’s expertise is merging information from our proprietary database with facility-specific, accretive outcomes to develop (and manage) a provider’s “Risk Profile.”  This proprietary measure serves to mitigate the provider-exposure endemic to shared savings initiatives and episodic payment models.  His “fee-for-service” roots enable Vincent to reconcile the conflicting incentives in a world where volume and value run parallel, to find the resonant balance best suited to the culture and vision of our unique provider clients.  Vincent lectures extensively on diverse topics associated with SNF technology, reimbursement, managed care and data analytics.  He is a graduate of Boston University in 2010 and earned his MBA from Rutgers University in 2017.

David Asher
Senior VP & Co-Founder — Longevity Health Plan

David Asher is a Senior Vice President and Co-Founder at Longevity Health Plan (LHP), a company dedicated to caring for the long term care population. LHP operates as a health plan in some states, and as an ISNP IPA in association with Humana and Aetna in others.  With over 20 years experience in the ISNP space, David is an expert on the evolution of the LTC/MA dynamic, and is an advocate of LTC operators "knowing their worth" in the world of Medicare Advantage.  As a former U.S. Navy Corpsman and with over 10 years serving as an advanced life support provider in NY, David brings a clinical perspective to the table as well.

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