House Calls Quick Hits: The Big Beautiful Bill and Its Impact on Skilled Nursing Facilities (SNFs)
Sep 30, 2025
A major legislative push aims to cut $1 trillion from Medicaid, putting intense pressure on skilled nursing facilities. Guest Andy Goldberg discusses how these operators are responding to reduced reimbursement rates and rising clinical complexities. Outsourcing operations and embracing new care models are emerging as essential strategies for survival. The conversation explores whether budget cuts could paradoxically drive improvements in quality through innovative practices and technology. Adaptability will be key for SNFs to navigate this shifting landscape.
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Huge Medicaid Cuts Intensify Pressure
- The One Big Beautiful Bill will cut about a trillion dollars from Medicaid and related programs over the next decade.
- That reduction will significantly increase financial pressure on acute and post-acute providers, especially SNFs.
Higher-Acuity Patients In SNFs
- Care is shifting from acute hospitals into skilled nursing facilities and patient severity in SNFs is increasing.
- That shift creates a 'perfect storm' raising operational and clinical demands on SNFs already facing tight margins.
Owners And Operators Decouple
- Facility owners are increasingly separating ownership from operations, resembling REIT-operator structures.
- This trend opens the door for outsourcing clinical operations to specialist operators.