CMS Reverses Course on Independent Consulting Pharmacists

In a move that most industry watchers including myself believed was unlikely to occur, CMS decided to reverse course on a proposal to require SNFs to have separate relationships for dispensing and consulting pharmacies/pharmacists.  CMS publicized its decision yesterday. About a month ago in a post I wrote regarding post-acute trends (http://wp.me/ptUlY-aO ), I indicated that … Read more

Financial Tests Before Additions, Renovations or New Construction

A frequent, recurring question that I field, especially for CCRCs and seniors housing providers is “what” financial feasibility tests are most important before a project is started or for that matter, financed.  Given that capital is still relatively tight, project feasibility and key financial tests are today, critically important to assure the best financing terms available … Read more

Post-Acute Issues Worth Watching

In my recent work and across recent discussions, phone conferences, etc., I’ve encountered a thematic trend; a circle of issues or as in reference to geese, perhaps a gaggle. Doing a bit of research and sifting through notes written over the past few weeks, here is what is trending. Pharmacy: In October of last year, … Read more

Medicare SNF Rate Outlook

Literally fresh off of a significant rate adjustment/reduction in October (2011), Medpac (the Medicare Payment Advisory Commission) releases a recommendation for complete SNF payment overhaul.  In their assessment of the SNF payment system under Medicare, Medpac concludes the following; Medicare payments to SNFs represent 23% of all revenues.  Medicare (payer) as a share of SNF patient … Read more

Medicare Fraud and Why; Part II

Last week I published a post regarding Medicare fraud that is occurring in the post-acute industry.  The post is available at http://wp.me/ptUlY-ak .  At the end, I indicated that I would provide a follow-up post; a closer piece more succinct on why the fraud trend is heating up and what the drivers for this trend are.  In … Read more

Medicare, Fraud and Why: Perspectives on the Post-Acute Industry

What never ceases to amaze me is the amount of post-news discussion that occurs when certain issues rise to the front-page (or near the front page).  Seemingly, industry side-liners awaken and look in disbelief that one major provider organization or another is again, embroiled in some OIG investigation, lawsuit or official inquiry concerning their Medicare … Read more

Current Policy Trends to Watch

In response to a recent series of questions from multiple segments of the health care and post-acute industry plus my own experiences within the landscape of providers and policy makers, I’ve summarized a current list of policy trends “pay attention to”. Medicare Cuts and the Super Committee: Nothing seems to loom larger or cast a … Read more

Post-Payment Reductions: Build a Revenue Model for Success

Not too long ago I wrote a post for SNFs regarding “what to do” in preparation for October 1 rate reductions.  Since then, I’ve fielded inquiries galore from all kinds of providers looking into a future that likely includes Medicare and certainly, Medicaid rate/payment reductions.  In most cases, the answer that I provide is clearly … Read more

SNFs: What to do Now for October 1

As known by now, a lot of change is occurring with Medicare effective 10/1.  Daily, I field questions from around the country regarding what exactly is happening and what if anything an SNF should do to “minimize” the impact.  To a certain extent, at least as far as reimbursement reductions go, it is difficult and ill-advised … Read more

Post-Acute Outlook Post Debt Ceiling, Post Medicare Rate Adjustments, Etc.

OK, the title is a bit wordy and trust me, I could have included more “posts” but I think I got the point across.  First, I’ll admit to having a crystal ball however, the picture I see is a bit like the first (and only) television set I remember having as a kid: Not in … Read more