The COVID-19 “new normal” for long-term care residents and families has heightened demand and interest for operators to provide additional clinical services within the long-term care setting, according to Ziegler. One of the ways operators are seeing to support increased demand for services — and ensure they are properly reimbursed for them — has been through partnerships based around Medicare Advantage and institutional special needs plans. In fact, according to data released by Ziegler Thursday, the number of I-SNPs has increased by more than a third since 2018. I-SNP enrollment as of last month stands at roughly 3.4 million individuals.
Many plans, such as those sponsored by AllyAlign, provide a coordinated care option on-site with dedicated physicians, nurse practitioners and primary care capabilities. AllyAlign notes that several COVID-19 emerging structural shifts pose even more benefits to operators with a special needs plan in place, such as:
- The management of complex patients, given that many hospitals are now actively discouraging transfers from the long-term care setting.
- Increased demand for senior living operators to provide clinical services, due to both decreased physical access to communities and a reluctance of seniors to leave their community for specialist visits. This shift is likely to increase the percentage of the resident health care spend that is dependent upon the senior living operator.
- Special needs plans that use remote access to connect with specialists and other providers via a telehealth platform designed for the long-term care setting will be ahead of others without such platforms.
“With the seismic shifts in our healthcare delivery models, those without sophisticated clinical networks and the inability to participate in at-risk plans will be left in the dark,” the report concluded.