In Feds to deliver ‘positive news’ on Provider Relief Fund in coming days: Parkinson, McKnight's LTC News summarized recent comments from AHCA President and CEO Mark Parkinson at the Synergy Summit in Utah.
Among other things, Parkinson stressed managed care is not going away and encouraged senior care providers to embrace it by:
- Becoming a top provider in a given market
- Improving demographics
- Becoming part of a network
- Taking advantage of institutional special needs plans (I-SNPs)
Naturally, you may want to know more about I-SNPs and if/how you might take advantage of them. The below Q&A may be of help to you in assessing this.
What is an I-SNP?
I-SNP stands for Institutional Special Needs Plan and is designed for those who will live in a long-term setting for 90 days or more with no immediate plans for discharge
How does it fit within Medicare?
An I-SNP is a Medicare Advantage plan focused on the care of specialized populations. It replaces traditional Medicare to cover inpatient and outpatient services, plus prescription drugs (as a Part D service).
Who is eligible for an I-SNP?
- Reside in a long-term care facility with no anticipated discharge
- Currently enrolled in Medicare A/B
- Live in a county where I-SNP is licensed
*Check CMS' Special Needs Plan (SNP) Data to see who is operating in your state.
What are the highlights of an I-SNP?
- Nurse practitioners provide preventative and proactive care
- RN case managers coordinate care according to the Model of Care (MOC) required by CMS
- Residents are assigned a 'Risk for Hospitalization' level, which determines care plan and a schedule for proactive rounds
- Rounds occur as often as weekly or can be more frequent for high-risk residents
- Provider visits are not subject to medical necessity requirements of traditional Medicare, so they can be more proactive and frequent
How do I-SNPs benefit SNFs/residents?
- Increased provider visits; faster identification of conditions/treatment
- Treatment-in-place advantage – visits can happen in the nursing facility
- Proactive and preventative care; prevents unnecessary hospitalizations
- Reduce risks and stress associated with hospital stays
How can technology help facilities with I-SNPs?
- Case-to-contract management is essential to following an ISNP
- Our Managed Care MASTER software brings contracts online, PLUS pairs them with best-practice workflows and alerts
- With this automation, you can easily train anyone to act as a case manager and ensure reimbursement
If our Managed Care MASTER can help you 'manage' your managed care, including I-SNP contracts and care, let's connect.