MA Winter Roundup for SNFs: small gains and continued pressure

Our Take: Skilled nursing operators are seeing gains from proactive Medicare Advantage contract renegotiation; CMS is expands oversight of MA prior authorization and mandates the elimination of fax workflows by 2028.  ▼

Growing federal pressure on Medicare Advantage payers may gradually improve reimbursement, timelines and documentation standards for post-acute care.


CMS Looks to Kill the Fax Machine

“Faxing remains entrenched in skilled nursing despite digital progress, and it isn’t just a tech lag, it’s a clinical risk. While 70% of healthcare organizations still cling to a fax machine, we have to acknowledge what that truly represents: fragmented handoffs, reordered tests, and delayed rehabilitative care. In long-term care, a paper jam isn’t a minor office inconvenience. It’s a barrier to a patient’s recovery.”

— McKnight’s Long-Term Care News, March 23, 2026

‘The 1980s Called’: CMS Finalizes Rule to Phase Out Fax, Mail

“The 1980s called, and they want their fax machines back. … This new rule will modernize American healthcare by standardizing electronic claims attachments and enabling secure electronic signatures. Because every minute providers save on paperwork is another minute they can spend caring for patients.”

— Becker’s Payer Issues, March 23, 2026

CMS Aims to Rebuild Trust, Fight Fraud with Prior Authorization Reform

“Prior authorization is ‘an enormous drain on the system, both from an administrative efficiency standpoint and as it fundamentally erodes the patient experience by prolonging [getting] access to care that their benefits should give them access to.’ … We want to minimize the administrative burden that comes with that prior authorization, build up trust between payers and providers and fundamentally improve the patient experience.”

— McKnight’s Long-Term Care News, March 17, 2026

AHR Lauds Trilogy Gains, Medicare Advantage Rate Momentum for Nursing Homes During Leadership Transition

“Willhite said 2025 was a ‘tremendous’ year for optimizing MA rates with insurers, and that pressures on length of stay, a major headache among operators, is ‘normalizing.’ Trilogy’s Medicare rate growth was closer to 5.2%, exceeding the 3% national average.”

— Skilled Nursing News, February 27, 2026

‘Money Ballers’: Nursing Home Leaders Rethink Medicare Advantage Woes, Short-Term Labor Fixes

“Several years ago, we conducted a comprehensive inventory of MA plans across our footprint, creating a centralized matrix that tracks reimbursement terms, utilization criteria, and renegotiation timelines. … As MA continues to reshape post-acute care delivery, we no longer view payer mix simply as Medicare versus everything else. Understanding variation within Medicare Advantage itself – by individual plan – has become essential.”

— Skilled Nursing News, January 27, 2026

‘Vertical Integration Is Destroying People’s Ability to Access Care’: Payer CEOs Face Bipartisan Congressional Grilling

“Whether you’re a blue-blooded capitalist or a card-carrying democratic socialist, I think corporate monopolies are a problem, and this vertical integration is destroying people’s ability to access care.”

— Becker’s Payer Issues, January 22, 2026

More Posts Like This One
Recent Posts

Payer Roundup – March 2026

Our Take: KFF data confirms MA remains the highest-margin insurance segment, and regional plans are capturing enrollment gains…

Find More Medicare Advantage Resources

stat-news on PayerIndex

Health Care’s Colossus

Our Take: STAT’s eight-part “Health Care’s Colossus” series documents how UnitedHealth Group built a vertically integrated machine, leveraging physicians, algorithms, and self-funded research. The UHG machine can systematically extract Medicare…
Read this article