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|June 20, 2019
MEDICARE ADVANTAGE PLANS INTERESTED IN HIGHER ACUITY SNF PROVIDERS
Medicare Advantage Plans Look for SNFs with the Ability to Accept Higher Level of Acuity Members
More than previous years, the Medicare Advantage health plans are specifically interested in skilled nursing facilities with the ability to accept higher acuity patients. Some health plans are requesting questionnaires as an entry point for negotiations that include specific questions related to clinical capabilities. Examples of the types of services Medicare Advantage health plans are requesting:
1. Can you take new/existing trachs? How new of a trach can you accept? **
** These items are repeatedly requested by Commercial payors
Some FAHA H&S members have indicated they are considering adding bedside dialysis and/or other specialized care to be more competitive.
RIPPED FROM THE HEADLINES
Hospital Exec: ‘Almost Nothing’ Won’t Move to the Home Amid Shift to Lower-Cost Care Settings. The siphoning of residents from skilled nursing facilities into the home health space remains a troubling trend for institutional operators, and an executive at one of the nation’s largest health systems sees nothing but acceleration ahead. Read more...
Health plan updates
Utilization Management – List of UM Nurses. Freedom Health provides a list of their Utilization Management and Concurrent Management nurses for all the counties they’re doing business in Florida. Read more...
Provider Resource Guide. Humana Medicaid Provider Resource Guide – Statewide. A variety of provider materials and resources are available on the Humana website (no registration required). Medicaid-specific materials, communications and quality resources can be found at Humana.com/Floridamedicaid. Read more...
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