Understanding the factors driving this increased utilization, such as shorter hospital stays and a growing preference for home-based care transitions, can help facilities adapt their services, staffing models, and marketing strategies to attract and effectively serve this growing population segment. At the same time, facilities must carefully navigate the complexities of Medicare Advantage contracts, including prior authorization requirements and differing reimbursement rates, to ensure financial sustainability amidst this evolving landscape.
In 2019, there were about 46.6 skilled nursing facility stays per 1,000 Medicare Advantage beneficiaries on a national basis.
That’s according to data released Monday by the Centers for Medicare & Medicaid Services (CMS), on the utilization of skilled nursing facilities among beneficiaries enrolled in Medicare Advantage plans.
The data also showed there were about 945 SNF days per 1,000 Medicare Advantage beneficiaries on a national basis in 2019.
The federal agency shares public use files (PUF) from time to time to support timely benefit and rate analysis for researchers and other stakeholders, and the latest information pertains to state-by-state variations in use of Medicare Advantage plans within SNFs. This latest data also includes metrics on SNF utilization and beneficiary demographic characteristics for Medicare beneficiaries. The data shared covers calendar years 2016 through 2019.
Of the data sets shared, the Medicare Advantage Geographic Variation National & State data set provides contains information on demographic characteristics and service utilization for hospital inpatient and skilled nursing facility services for Medicare Advantage beneficiaries at the national and state levels for Medicare beneficiaries who were enrolled in MA for the full year.
Siddiqi, Z. (2023, June 13). CMS releases new data on Medicare Advantage Beneficiaries’ use of skilled nursing. Skilled Nursing News. https://skillednursingnews.com/2023/06/cms-releases-new-data-on-medicare-advantage-beneficiaries-use-of-skilled-nursing/
Improve Medicare Advantage reimbursements with payer contract management that puts payer rules in the hands of clinicians & billers.
