Subsidizing Managed Care with FFS Revenue – Good idea or not?

Many skilled nursing executives have an old mantra concerning Managed Care “Win some, Lose some.”

But is that a good financial strategy for 2016 and beyond? With many Alternative Payment Models using insurance products, and many regional integrated healthcare systems doing the same, beneficiaries on insurance products are increasing across the “new payer” board.

It’s a business model that’s not going away. Let’s look at the facts.

Managed Care census grew slowly across the country over the past 4 years. It snuck up on the skilled nursing industry whose process was based on only 2-3 payers.  Then the differences in each insurance product brought new complexities to what used to be a well-oiled 2-3 payer system.

We can all pretend that insurance products will go away as long as there is Fee-For-Service revenue that takes its place. But how long will that last in a healthcare environment that is now willing to take on more financial risks?

Stop and ask yourself, can you continue to gamble Fee-For-Service revenue into the future?

Success in the future starts with looking at this challenge in a new way. Let us show how winning financially in a growing Managed Care market is more than possible and not as hard as you might think.

Recommended Posts