CBO Releases Updated ACA Score

Tuesday, the Congressional Budget Office released their updated score of the ACA post the Supreme Court ruling.  Substantively, the only reason or need for an update is the Court’s tweak concerning Medicaid expansion; allowing states to opt-out of expansion.  See my post from earlier this week for a bit more information on the Court’s ruling and … Read more

CBO Score on Post-Court ACA Implications Due Today

Later today, the Congressional Budget Office is set to release an updated “score” of the Affordable Care Act (PPACA) incorporating the decision of the Supreme Court.  The fundamental reason for the update is the Court’s decision to invalidate a provision within the Act that would have penalized states via reduced federal Medicaid funding should one or more opt … Read more

What’s Trending: A Hot Friday Perspective

Seems every day this month has been hot and dry – could use a break from the heat  and definitely, some prolonged rain.  Within the past couple of weeks, I’ve traveled “rural” a bit and as a result, I have a different perspective on what farmers and ranchers in the middle-section of the country are struggling … Read more

An Omission from Friday

Every once in a while, I make a mistake (rare I think but others when asked, would convey a different sentiment).  This gaff is really an omission; a missed thought from Friday’s post on “What’s Trending”.  In reviewing my notes (the mess that they can be), I noticed I forgot to include a “watch” tip for … Read more

What’s Trending: A Friday the 13th in July Perspective

Back after a week of vacation (sort of) and then a week of scramble to catch up, here’s the latest that I am watching and that I find trending from readers and clients. Medicaid and Health Care Reform: Oddly, this has been a Medicaid week for me on a number of fronts.  The Supreme Court decision … Read more

Supreme Court Upholds the PPACA

In a surprising ruling, the Supreme Court upheld the constitutionality of the PPACA, in its entirety.  Earlier in the week I wrote that my view, substantiated via conversations with many insiders ranging from lawyers to professors to think-tank analysts, was that the Court would find the core of the law unconstitutional.  My guess is that many … Read more

SNFs: Its All About Quality Now

Across a recent engagement that spanned a large system, wide geography and about a year’s worth of work, I had the chance to reflect numerous times on “what” has changed in the post-acute arena, particularly applicable to SNFs, over my 30 years.  Below I’ve organized my thoughts in “eras” or periods of time. Cost Based/The … 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

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