National Seeking Feedback on NaviHealth and nhPredict
LeadingAge National received a media query seeking information on what providers are seeing related to the current use of United Healthcare’s NaviHealth tool and other Medicare Advantage plan tools. The reporter with media outlet STAT news would like to talk directly with members who are willing and that the conversation can either be on the record (for identification and quoting) or on background (information shared but the person interviewed remains anonymous). Here are some questions he may be interested in:
- Is the nhPredict tool being used more or less frequently than a year ago or about the same?
- Are plans still rigidly following the prescribed number of SNF days outlined in the report or are plans now also considering changes in condition, looking at progress notes and other EHR information before issuing Notices of Medicare Non-coverage (NOMNCs)?
- Are you appealing NOMNCs issued based on the nhPredict report in cases where the individual still requires care? If so, how successful are these appeals?
- What else would you say about the nhPredict tool or any other similar tools being used by plans?
- What would you want policymakers or the public to know about how these tools are being used by plans to deny care or terminate care earlier than the person’s needs would suggest?
- Anything else you would like to share
How to provide feedback: Please email Nicole Fallon with any information on this topic and she will plan to aggregate it and share it with the reporter but will not name you or your organization. Alternatively, if you would be willing to speak with the reporter, let her know and she can coordinate and so National’s Communications team can be present for the discussion.
Impactful Leadership Deserves Recognition: 2026 Leadership Award
In 2024, Pamela Garofolo was honored for transforming dementia care and empowering residents, staff, and families at UMC – Abundant Life for Seniors. In 2025, Kim Gaskell was recognized for her collaborative, people-centered leadership at RiverWoods. Who will earn this distinguished honor in 2026? Submit a nomination by February 27.
The LeadingAge Leadership Award recognizes an individual in a member provider organization whose leadership attributes have made a significant difference in their organization or local community. It is open to leaders at all levels, including those who serve in non-CEO and non-C-suite roles. The recipient makes contributions that lead to greater success and impact for their organization, shows exceptional leadership skills in relationships with other community stakeholders, and drives change, especially in ways that can be quantified or measured. Nominations for the 2026 Leadership Award are now open and will close on February 27. The award will be presented at the 2026 LeadingAge Summit.
CBO: H.R. 1 Speeds Medicare Part A Insolvency by 12 Years
According to a blog posted by the nonpartisan Congressional Budget Office (CBO) on February 23, the 2025 reconciliation act will speed up the insolvency of the Medicare Hospital Insurance Trust Fund by 12 years due to the law’s reduction in tax rates and temporary deductions for those 65 and older. This means Medicare could stop paying full Medicare Part A payments to providers by 2040. The trust fund pays for benefits under Medicare Part A, which covers inpatient hospital services, skilled nursing facility stays, home health care, and hospice care. The majority of the funding comes from Medicare payroll taxes and Social Security benefit taxes.
This is a stark revision from CBO’s estimate in 2025 which stated the trust fund would not be able to pay full benefits beginning in 2052. If this were to happen, and the trust fund was depleted by 2040, total benefits would need to be reduced by 8% in 2040 to 10% in 2056. According to CBO, the decision on how to make those reductions would be left to the Centers for Medicare and Medicaid Services. Two other factors were cited in the sped-up timeline for insolvency: reduction in payroll taxes from projections of lower earnings and lower interest income from the trust fund. While overall taxes contributed to the trust fund are being reduced, spending of the trust fund is also increasing. CBO found that overall spending on Medicare beneficiaries is projected to increase due to per enrollee spending in 2025 Part A fee-for-service Medicare along with higher Medicare Advantage plan bids in 2026.
Tips for Submitting Comments on Department of Education Rule
The Department of Education has published a rule that will impact access to federal student loans for individuals pursuing higher degrees in a number of fields relevant to the aging services sector. The comment deadline is Monday, March 2, 2026, at 10:59 p.m. CT. LeadingAge will be submit comments and we encourage members to comment as well. The information in this tip sheet is intended to guide provider members who wish to comment through the process.
