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Executives from three large nursing home providers said at Skilled Nursing News’ RETHINK conference that they have challenged or ended Medicare Advantage contracts they consider financially inadequate. Saber’s Bill Weisberg said the company ended five to seven contracts in the past 24 months, while the executives also called for stronger advocacy and policy changes.
Executives from Saber Healthcare Group, Creative Solutions in Healthcare and Majestic Care said at Skilled Nursing News’ RETHINK conference in Philadelphia that their organizations have challenged or ended some Medicare Advantage contracts over reimbursement they say does not cover the cost of care. The comments highlight a financial and operational strain for nursing home providers, as well as disagreement over whether plans deliver the referrals and improved economics that operators may expect.
Saber has ended five to seven contracts over the past 24 months, President and Founder Bill Weisberg said. One of those contracts ended about two weeks before the conference because, he said, the plan did not cover the cost of care. Weisberg said operators can face a poor trade when they accept lower rates in exchange for the prospect of more referrals: Medicare Advantage plans cannot determine where patients ultimately go, he argued, because discharge planners, families and communities influence those decisions.
Weisberg said Saber uses cost-of-care, length-of-stay, readmission and outcome data in negotiations. He described cases in which plans returned to talks after Saber presented comparative figures and sought an additional $25 to $35 per day, with the provider receiving a higher rate. He characterized the negotiations as a “game of chicken,” in which a provider may walk away but also may use its data to make a case for better terms.
Creative Solutions CEO Gary Blake said his organization is also willing to leave contracts and informs residents and families about coverage options, including other plans or traditional Medicare. Majestic Care CEO Paul Pruitt said operators are expected to meet quality and cost targets, but in his view that performance does not reliably lead to more referrals, patients or profit for providers. Both Blake and Pruitt also called for policy changes and continued discussion with lawmakers.
Contract Choices Shape Nursing Home Revenue
Medicare Advantage contracts can affect both the payment nursing homes receive and the patients they serve. When a provider ends an agreement, it may give up potential plan referrals, while residents enrolled in that plan may need to consider other coverage or facilities. The executives’ accounts show how providers weigh those risks against rates they say fall short of care costs.
The remarks also point to a tension between financial targets and clinical decisions. Blake and Pruitt said plan payment reductions or pressure to discharge patients can make it harder for staff to focus on care, including when clinicians believe a resident is not ready to return home. Their statements describe provider concerns; the conference report does not establish how common these situations are across the sector or how individual plans would characterize them.
How Providers Approach Plan Talks
The executives spoke during the opening session of Skilled Nursing News’ RETHINK conference, held in Philadelphia in September 2026. The discussion focused on nursing home operators’ financial and operational experiences with Medicare Advantage plans, a form of private health coverage for people eligible for Medicare.
Weisberg described two approaches Saber uses: ending contracts it considers inadequate and negotiating with plans using performance and cost data. Blake described educating residents and families about their coverage choices. Pruitt framed the broader challenge as a system that asks providers to meet quality and cost measures while, in his view, often failing to deliver corresponding financial benefits.
““We will walk away from those contracts, but we also go into them when we negotiate.””
— Bill Weisberg, Saber Healthcare Group president and founder
Scope of Contract Disputes Remains Unknown
The conference account does not identify the plans Saber left, the facilities or residents affected, or the total number of residents whose coverage may have been involved. It also does not provide contract documents or responses from the Medicare Advantage plans discussed by the executives. The reported $25 to $35 per day figure refers to additional reimbursement Saber sought in some negotiations; the account does not specify the number of cases or a time period for those examples.
The executives’ experiences do not establish how widespread low reimbursement or discharge pressure is across nursing homes. The report also does not detail what policy changes lawmakers may consider, or whether ongoing discussions will lead to legislation or regulatory action.
Providers Continue Data Talks and Advocacy
Weisberg said Saber will continue to use operating and care data in negotiations and end contracts it considers inadequate. Blake said Creative Solutions is continuing discussions with lawmakers in Washington. Pruitt described advocacy as a way to press for better outcomes for seniors while acknowledging that Medicare Advantage plans are not going away.
No specific legislative proposal, decision date or next negotiation milestone was given in the conference account. The next developments will depend on whether providers secure revised contract terms and whether their discussions with lawmakers produce policy proposals.
Key Questions
Why has Saber ended some Medicare Advantage contracts?
Bill Weisberg said Saber ended contracts it considered inadequate, including one that he said did not cover the cost of care. He said the company had ended five to seven contracts in 24 months.
What data does Saber use in negotiations?
Weisberg said Saber reviews cost of care, length of stay, hospital readmissions and outcomes to make its case for reimbursement. He cited some negotiations where the company sought an additional $25 to $35 per day and received a higher rate.
What coverage options did Creative Solutions say it discusses with residents?
Gary Blake said the company educates residents and families about their plan and other coverage choices, including other Medicare Advantage plans or traditional Medicare. The conference account does not describe individual residents’ circumstances or plan eligibility.
Are lawmakers considering a specific change?
The account says Creative Solutions is in ongoing discussions with lawmakers and that Blake called for policy change. It does not name a specific proposal, timetable or expected legislative action.
Source: rss
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