Healthcare, Senior Living, Economics
There hasn’t been much open discussion this political season with regard to health policy/healthcare. What there has been is predominantly centered around abortion, reframed as reproductive healthcare or women’s healthcare. To a lesser extent, the Harris campaign has touted prescription drug price reductions, including a $2,000 cap on Medicare out-of-pocket drug costs beginning in January … Read more
On September 30, US District Judge Kathryn Kimball Mizelle from the Middle District of Florida ruled in a landmark decision that the qui tam provision of the federal False Claims Act (FCA) is unconstitutional. This ruling could have significant impact on whistleblower (Qui Tam) actions filed against healthcare providers, particularly home health and hospice (most … Read more
Marsh (largest insurance broker in the world) recently released its 2024 General and Professional Liability Report 2024-General-Professional-Liability-Benchmark-Report-MAR-USA. The report includes data from fifty senior living and long-term care providers comprising 10,300 closed claims with paid indemnity and expense value of $1.87 billion across a ten-year horizon. The ten-year data was used by Marsh to forecast … Read more
According to a recent Fitch Ratings report, employment levels at life plan/continuing care retirement communities (CCRCs) and SNFs are still 5.90% lower than before the pandemic. Life Plan Communities Labor Tracker: September 2024 (fitchratings.com) Per Fitch, the causes are many, but the number one challenge is demand for staff which exceeds supply. Overall, options for … Read more
Among the many challenges providers have faced economically, higher borrowing rates (interest) has remained in the top three. For senior living, higher capital costs and tighter borrowing conditions (LTV, more restrictive covenants, etc.) have all but slowed new development to a halt. Higher borrowing rates are at the bank level, a function of Federal Reserve … Read more
Here’s an oldie but a goodie for today. The House Ways and Means Committee is reportedly considering a markup of legislation this month that would revamp Medicare’s physician payment system. This move could increase the likelihood of incorporating a “doc fix” into a lame duck legislative package. Historic readers and followers of Reg’s Blog will … Read more
Not sure how many times I’ve heard the worn phrases of “think outside the box”, “brainstorm”, “explore new perspectives”, across my career. Now, I’m not saying that these concepts don’t have merit. I am however, saying that most often, the best innovation comes from “thinking inside the box”. Systematic inventive thinking: the power of thinking … Read more
Tonight’s presidential debate should be policy focused but likely, won’t be or won’t be with sufficient detail. There are a ton of policy issues that should be discussed. Healthcare policy, in my opinion, should be very much a topic of open and frank discussion. I know I am a geek when it comes to economic … Read more
Nursing assistants are anticipated to experience the largest projected shortfall among all healthcare occupations analyzed, with an expected national shortage exceeding 73,000 assistants by 2028. This projection is based on a report by Mercer, which also predicts a nationwide deficit of over 100,000 healthcare workers by the same year. The demand for nursing assistants is … Read more
Late last year, CMS proposed a final rule to address the issue of coverage denials or service denials via prior authorization on behalf of Medicare Advantage Plans. Between providers and patients, coverage issues have significantly increased as beneficiary participation has increased (today, about 1 in 2 Medicare beneficiaries is in a Medicare Advantage plan). https://rhislop3.com/2023/11/09/cms-offers-fix-to-medicare-advantage-denials/ … Read more