Health Care Reform: Getting to the Details

Its been about ten days since the House passed its version of health care reform and just now,  it is possible to unwind and assess some of the cost/price details that are buried within the 2,000 page bill.  Similarly, it is also possible for the general public to begin the process of digesting the ramifications … Read more

Health Care Reform in the House: A Post Mortem

Late Saturday night by the slimmest of margins, the House of Representatives passed H.R. 3962 otherwise known as the Affordable Health Care Act for America – three votes the other way and the Bill would not have passed.  The Bill weighs in at over 2,000 pages (2,034) and represents the first major “stab” at reforming … Read more

Affordable Health Care for America Act: Implications for SNFs

This weekend, the House is reportedly set to vote on their version of healthcare reform – H.R. 3962.  The bill is a “monster”; nearly 2,000 pages long.  The title belies the fact that the Bill doesn’t just attempt to create “affordable health care” – it goes much, much further.  For example, embedded within the hundreds of … Read more

CMS Releases Hospice Stats

Within the past two weeks, CMS released data from 1998 to 2008 for length of stay and diagnosis trends.  What is interesting to note is the utilization trends (length of stay and numbers) over the period as well as the diagnosis correlated to utilization.  For CMS and in particular MedPAC, the prevailing concern has been … Read more

Healthcare Reform: Now the House Version

Earlier today, Speaker Pelosi introduced the re-tooled House version of healthcare reform, now titled The Affordable Health Care Act.  The 2,000 page bill is the result of weeks of backroom negotiations designed to forge a possible consensus, principally among Democrats, and to financially wrangle, a targeted budget neutral spending level.  According to Pelosi, the Bill … Read more

Healthcare Reform Update: Inside Baseball Time

If you are a baseball fan, you’ll appreciate the correlation between a baseball game and the present course of healthcare reform.  A baseball game starts with anticipation and fanfare; speeches, the throwing out of the first pitch, the national anthem and the players taking the field.  The fans settle in and the game begins with cheers … Read more

CCRCs and Problems: Much Ado About Likely, Very Little

A product that has seen its share of struggles in the economic downturn is entry-fee CCRCs.  To clarify, not all CCRC models are struggling and not even all entry-fee based CCRCs are struggling as certain regions have seen less housing market fall-out and concurrently, operators have done the right things to keep their census stable during the “down … Read more

Getting Risks Under Control: Improving Organizational Prosperity

Healthcare is a risky business; particularly in heavily regulated environments such as nursing homes and home health and hospice.  The fact that a certain level of risk is omnipresent means that the opportunity constantly exists for an organization that improperly identifies and manages its risks, to suffer expensive damages ranging from financial loss to loss … Read more

OIG Reports Published on Hospice

In a post I wrote at the end of July concerning CMS’ 2010 rate announcement and compliance and regulatory trends, I indicated how the OIG was becoming more vigilant in reviewing hospice utilization, lengths of stay and in particular, the correlation between lengths of stay and hospice patients in an SNF.  This past month, in mid-September, the … Read more