Healthcare, Senior Living, Economics
In nearly all provider segments of health care, revenue maximization and integrity are directly tied to compliance and quality ratings. In home health, submission of quality data via the OASIS (known as HH CAHPS) is required. Agencies that fail to submit the required data experience reimbursement reductions of 2%. For SNFs, reporting of QRP data … Read more
Spring is the time when CMS starts dropping Proposed Rules for various health care provider segments. This past week or so saw update drops for IRFs, Hospice and SNFs. Recall, Proposed Rules are administrative law changes that CMS makes to existing provider regulations, typically covering reimbursement and some programmatic policy changes that tie to reimbursement. … Read more
I spend a good (ok, large) amount of time working with non-profit and privately held health care, post-acute and seniors housing organizations. Nearly all of my work is at the C-level and above and frankly, my career as an executive was there as well (25 plus years). Boards/governance bodies play a key role in the success and/or failure of … Read more
Late this afternoon, I caught news that CMS will release a number of Final Rules impacting post-acute providers over the next few days. Below is a quick summary of what is known for SNFs. I will update this information as I get access to the Final Rule. PPS rates (manual) to adjust by 2.4% (increase). A … Read more
In a memo set for release today, CMS is proposing to reintroduce pre-payment review (with a twist) for Home Health claims. The memo version is here: HHA Pre Payment Recall, CMS first introduced pre-payment review in August 2016, starting in Illinois. The process required agencies to submit claim-related data BEFORE receiving final payment or face an … Read more
Last Friday, CMS released the contents of its annual proposed rule updating the SNF PPS plus (as always), fine tuning certain related programmatic elements. Final Federal Register Publication is set for May 8. (Anyone wishing the PDF version may download it from the Reports and Other Documents page on this site or access it here … Read more
Just ahead of the Fourth of July holiday, CMS released its proposed home health rule changes for FY 2015. As common, the proposal includes rate changes/modifications and clarifications and adjustments to Conditions of Participation. The proposed rule continues a path for CMS and the industry of rate reduction/rate rebasing and movement toward greater emphasis on … Read more
In news just released, Kindred (the post-acute, skilled, rehab and LTAcH behemoth) has made two separate offers to purchase control of Gentiva, the latest a $14 per share offer consisting of half cash, half stock ($7 and $7). An earlier offer of $13 per share was rejected and it appears the $14 offer will see … Read more
Over the course of many engagements plus my years as an executive, I’ve addressed and been asked to address, the theme of effective governance, particularly at the Board level. To bring this topic into full context, one of my many “hats” that I wear (periodically), is as an advisor to graduate and post-graduate students working … Read more
A couple of weeks ago, I wrote a post covering the Home Health PPS Final Rule for 2014. As I was writing that post, I simultaneously reviewed the Gentiva/Harden deal plus the recent quarterly earnings of Amedisys and Almost Family (plus their acquisition of SunCrest HealthCare). The earnings reports plus the analytics from these two … Read more