SCAN Health Plan Bypasses Hospital Stays Before SNF Admission
SCAN Health Plan is eliminating the requirement that members undergo an inpatient hospital stay before transitioning from home to a skilled nursing facility, according to Home Health Care News. Some payers require a two-day hospital stay before authorizing a SNF transition, but SCAN is moving toward direct home-to-SNF pathways when appropriate. The move reflects a broader trend of home-based care providers gaining more influence over care-pathway decisions traditionally controlled by hospital-centric authorization rules. While SCAN's Medicare Advantage plans are the direct focus, the approach signals a model Medicaid managed care organizations covering dual-eligible and LTSS populations may watch closely.
Health plans managing post-acute and LTSS benefits should watch this as a model for reducing unnecessary inpatient utilization while still authorizing SNF-level care.
LTSS · Managed Care
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