Value-Based Care: What it is and How it Can Work for Post-Acute Providers

I get asked about value-based care a lot. It is a buzzword or term these days, somewhat driven by the rise in Medicare Advantage enrollment. Frankly, it is a bit of a catch-all concept that has its origins in Medicare and various demonstration projects (e.g., bundled payments) and the implementation of quality measures to “improve … Read more

OIG Issues Report on SNF Emergency Preparedness

Since the COVID pandemic, regulatory officials have escalated the review, via various audits, of SNF emergency preparedness. COVID highlighted the sporadic and often, non-existent preparations for disasters (natural and other) and disease outbreaks (pandemic or other) that existed with the SNF industry. In reality, the issues have been present for years but only regionally, highlighted … Read more

Hospice Special Focus, IDR, and Quality Reporting Program – 2024

Somewhat buried within the Home Health Final Rule (PPS) was an update on a CMS initiative to identify hospice agencies requiring additional regulatory oversight for poor care performance (poor quality, unsafe care practices). Back in 2021, CMS began the Special Focus initiative and in the 2024 Hospice Final Rule, CMS indicated that the recommendations for … Read more

Friday Feature: Senior Living Credit/Borrowing Still, Very Soft

TGIF! This week has been very busy with lots of data and lots of economic news. We got a new report from the BLS on inflation. We got earnings reports from Home Depot, Target, and yesterday, Wal Mart indicating what we saw from the Conference Board – consumers are slowing their spending.  I called the … Read more

Non-Profit Ownership/Sponsorship Changes Moving at Record Pace

While mergers and acquisitions are generally down, affiliations, closings in some cases, and sponsorship changes in non-profit senior living and care are at a record pace. Back in July, I wrote about the disconnect between acquisitions and the merger/affiliation changes occurring among non-profits. That post is here: https://rhislop3.com/2023/07/24/senior-living-and-care-ma-two-worlds/ A news release from Ziegler Investment Banking, … Read more

Wednesday Feature: CPI, Economy, 40 Days to Christmas

OK, the title is kind of funky, but these concepts do connect. Yesterday, the Bureau of Labor Statistics released the Consumer Price Index (inflation report) for October, 2023. Good news? Maybe. A mixed bag? Definitely. Headlines win the day, and politically spun, it’s fascinating to see which numbers resonate. The full report/release is here: cpi … Read more

Hospice Payment Basics/MedPAC

Even after all of the years that I have been in health care and particularly, post-acute care, I still field a good number of questions regarding Hospice, the benefit under Medicare, how payments work, and what the generalized payment amounts are. Having started a few hospices in my career, I can attest that done right, … Read more

Home Health 2024 Final Rule Released

On November 1, CMS issued the final PPS rule for Home Health (2024). The majority of provisions within this rule, especially those related to payment, take effect on January 1, 2024. The Final Rule as published is available for download here: Home Health 2024 Final Rule In July I wrote a post on the proposed … Read more

CMS Offers Fix to Medicare Advantage Denials

An issue that has been tied to AI (artificial intelligence) and specifically, to Medicare Advantage plans, involves coverage denials. I wrote about this in a post earlier this year at https://rhislop3.com/2023/05/01/medicare-advantage-part-d-final-rule/ Coverage denials have been a fairly hot topic around Medicare Advantage plans. The core of the issue is that Medicare Advantage plans are required … Read more

Wednesday Feature: A Bit of Economic Nostalgia

Happy Hump Day! I was going back through some historic stuff and I landed in 2010. The year 2010 was, after further review, eerily similar to right now, economically speaking. Sadly, not much has changed in terms of health policy and the economic state of healthcare. In 2010, the economy was choppy, recovering or trying … Read more