For skilled nursing facilities, MedPAC’s finding that MA plans substitute home health for post-acute SNF stays represents a direct threat to admission volume and revenue.
June 2025 Report to the Congress: Medicare and the Health Care Delivery System
Examining home health care use among Medicare Advantage enrollees. Using a combined dataset of the encounter and home health assessment data, the Commission assesses use of home health care by MA enrollees.
Medicare beneficiaries in nursing homes. The Commission describes the Medicare long-stay nursing home (NH) population and reviews regulations and programs that CMS has implemented to improve NH quality, including specialized MA plans known as institutional special-needs plans.
— MedPAC, June 12, 2025
Medicare Payment Advisory Commission. “June 2025 Report to the Congress: Medicare and the Health Care Delivery System.” MedPAC, 12 Jun. 2025. https://www.medpac.gov/document/june-2025-report-to-the-congress-medicare-and-the-health-care-delivery-system/.
MedPAC Urges Reform of Medicare Advantage, Noting ‘Design Flaws’ in Nursing Home Payment Models
While Centers for Medicare & Medicaid Services (CMS) has made improvements following previous recommendations from the Medicare Advisory Commission (MedPAC), the Medicare Advantage (MA) program and the value-based purchasing program still suffer from “design flaws,” according to the organization. MedPAC is calling attention to what it perceives as design flaws in the programs, including incentives that are too small to influence behavior among nursing home operators. In its June report to Congress, MedPAC called on Congress to enact meaningful reform of MA plans.
— Skilled Nursing News, June 13, 2025
New MedPAC report highlights nursing home and I-SNP trends.
Most importantly, MedPAC specifically discusses provider-sponsored I-SNPs – noting their growing role in the delivery of care within nursing homes. The report includes data points that distinguish provider-sponsored I-SNPs from other plan types, highlighting their potential to improve care coordination and outcomes through closer integration with facility operations.
— AHCA, June 24, 2025
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