Nursing Assistants = Supply Shortage

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

Check: Medicare Advantage Coverage Issues

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

Nursing Home Closures Creating Access Issues

With increasing older adult demand for hospital care, an ongoing wave of nursing home closures is creating post-acute access issues. Since 2020, 774 nursing homes have closed, and only seven new facilities opened in 2024. The primary driver for closure is a nationwide shortage of qualified clinical staff, exacerbated by the COVID pandemic.  The pandemic … Read more

Healthcare Fraud is Rampant and so are Costs

The U.S. spends more than any other world nation on healthcare – gross dollars and per capita. The systemic growth of spending continues at rate beyond inflation, spurred-on by an aging demographic and chronic diseases like diabetes and obesity.  Cost growth in programs like Medicare is rampant but then again, so is fraud. Federal spending … Read more

Exploring Age-Friendly Healthcare Programs

The Accreditation Commission for Health Care, Inc. (ACHC) has launched two new specialty credentials for organizations providing home care and/or hospice.  These programs are in line with the Age-Friendly Health Systems (Care) programs and initiatives started by The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and … Read more

Eighteen CCRCs Impacted by Fitch Ratings Update

Last week I wrote about Fitch Ratings updates to their non-profit CCRC rating criteria.  The expectation with the changes was that twelve percent of the rated CCRCs could be subject to Under Criteria Observation (UCO). What has occurred as a result of Fitch Ratings Update is that eighteen CCRCs have been impacted, falling under UCO.  … Read more

TEAM Model and Post-Acute Care

The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute care providers. Transforming Episode Accountability Model (TEAM) | CMS The Transforming Episode Accountability Model (TEAM) is set to be a … Read more

Senior Living Bankruptcy Trend Remains Alarming

The healthcare sector has experienced another quarter of record-high distress levels, as indicated by the volume of bankruptcy filings, with the senior living and care sector at the forefront. This bankruptcy trend for senior living remains alarming. In January, I took a look at 2023 bankruptcy levels, the worse year in decades.  That post is … Read more

Donald Trump “Likely” Health Policy

A number of weeks back I looked at what was known and could be divined about Kamala Harris’ health policy.  Today, with the election getting close (less than 70 days out), it’s an opportune time to look at Donald Trump’s likely health policy positions. The Harris post is available here: https://rhislop3.com/2024/07/23/kamala-harris-likely-health-policy/ Both candidates have shared … Read more

Phantom Diseases and Medicare Advantage Fraud

According to a Wall Street Journal article from August 4, Medicare Advantage plans are using home nurse visits to identify possible or questionable disease states/conditions (so called, phantom diseases) via screenings.  These diagnoses then turn into what appears to be, possible events of fraud via additional reimbursement tied to these new-found conditions. Exclusive | The … Read more