Healthcare, Senior Living, Economics
Political and health policy information specific to Wisconsin
The oldest boomers are about to turn 80 in 2026. This age point is typically the trigger point for advancing needs in secure living environments, services increase (ADL and IADL support), and increasing healthcare consumption. The baby boom generation is defined as folks born between 1946 and 1964. The “boom” reference is the rapid number of children … Read more
Genesis is one of the country’s largest SNF and assisted living providers so naturally, it saw its share of COVID cases throughout the pandemic. Like other similar providers across the same industry, cases involving COVID infections are just now hitting the courts. Back in October, I wrote about the advancement of litigation involving COVID. There … Read more
It was only a matter of time before litigation came forward regarding the use of Artificial Intelligence (AI) in primarily, Medicare Advantage plans, where coverage denials/determinations are at issue. This week, a class action suit dropped in the U.S. Circuit Court of Western Kentucky against Humana. A link to the suit is here: https://www.scribd.com/document/692182281/Humana-AI-NaviHealth-MA-lawsuit In … Read more
Happy Hump Day! Only 12 more shopping days until Christmas! In mid-November, CMS issued a final rule titled: “Medicare and Medicaid Programs; Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers’ Disclosure of Private Equity Companies and Real Estate Investment Trusts“. The final rule is … Read more
Yesterday I wrote about MedPAC’s rate recommendations for SNFs for FY 2025. Recall, MedPAC makes these recommendations annually, assuming the full commission votes (in January 2024) for the recommendations as released by draft. The final recommendations go to Congress. Yesterday’s post was the “draft” position for SNFs. Today, I’m including summaries for Home Health, Hospice, … Read more
The Medicare Payment Advisory Commission is (likely) recommending to Congress a series of post-acute rate reductions (Medicare, Fee-for-Service) for federal fiscal year 2025 (beginning October 1, 2024, for most programs, January 1, 2025, for Home Health Agencies). Specifically, the MedPAC recommendations are as follows. Reduce the 2025 payment rate for home health agencies by 7%. … Read more
TGIF and Happy Hanukkah (to my Jewish colleagues and friends)! A major concern as the demographic in the U.S. ages is senior housing and services affordability. The expanding cohort of seniors in terms of real purchasing power, is not as financially fit as prior generations. The Baby Boomers for example, while well paid in their … Read more
I follow Medicaid but don’t often get many inquiries around Medicaid policy or requests for articles in this subject area. Medicaid, however, is very important for providers, especially post-acute and senior living, as it is typically, a significant if not majority payer. During COVID and the public health emergency, Medicaid policy and CMS enacted requirements … Read more
Happy Hump Day! Advent has begun and soon, Chanukah will kick-off. ‘Tis the season or seasons. I will no doubt say this (or write it) many times over, but it always bears repeating, Happy Holidays to all! Yesterday, I wrote a post about Fitch Rating’s and their outlook for CCRCs/Life Plan communities for 2024. Fitch maintained … Read more
Among the many topical areas I watch in health care, I pay particular attention to liability and litigation. As frequent readers/followers know, my firm, H2 Healthcare, LLC, focuses a practice area on clinical compliance and litigation support. My wife and the firm’s Senior Partner is one of the foremost experts (nationally) in litigation support and … Read more