Value-Based Care: What it is and How it Can Work for Post-Acute Providers

I get asked about value-based care a lot. It is a buzzword or term these days, somewhat driven by the rise in Medicare Advantage enrollment. Frankly, it is a bit of a catch-all concept that has its origins in Medicare and various demonstration projects (e.g., bundled payments) and the implementation of quality measures to “improve … Read more

Hospice Special Focus, IDR, and Quality Reporting Program – 2024

Somewhat buried within the Home Health Final Rule (PPS) was an update on a CMS initiative to identify hospice agencies requiring additional regulatory oversight for poor care performance (poor quality, unsafe care practices). Back in 2021, CMS began the Special Focus initiative and in the 2024 Hospice Final Rule, CMS indicated that the recommendations for … Read more

Non-Profit Ownership/Sponsorship Changes Moving at Record Pace

While mergers and acquisitions are generally down, affiliations, closings in some cases, and sponsorship changes in non-profit senior living and care are at a record pace. Back in July, I wrote about the disconnect between acquisitions and the merger/affiliation changes occurring among non-profits. That post is here: https://rhislop3.com/2023/07/24/senior-living-and-care-ma-two-worlds/ A news release from Ziegler Investment Banking, … Read more

Home Health 2024 Final Rule Released

On November 1, CMS issued the final PPS rule for Home Health (2024). The majority of provisions within this rule, especially those related to payment, take effect on January 1, 2024. The Final Rule as published is available for download here: Home Health 2024 Final Rule In July I wrote a post on the proposed … Read more

CMS Offers Fix to Medicare Advantage Denials

An issue that has been tied to AI (artificial intelligence) and specifically, to Medicare Advantage plans, involves coverage denials. I wrote about this in a post earlier this year at https://rhislop3.com/2023/05/01/medicare-advantage-part-d-final-rule/ Coverage denials have been a fairly hot topic around Medicare Advantage plans. The core of the issue is that Medicare Advantage plans are required … Read more

Wednesday Feature: A Bit of Economic Nostalgia

Happy Hump Day! I was going back through some historic stuff and I landed in 2010. The year 2010 was, after further review, eerily similar to right now, economically speaking. Sadly, not much has changed in terms of health policy and the economic state of healthcare. In 2010, the economy was choppy, recovering or trying … Read more

3rd Quarter Senior Housing Update

Senior Housing has had a long, slow grind toward recovery, post-pandemic. Fitch classified the Life Plan component as “deteriorating”. Among the many challenges the industry sectors (Independent, Assisted, Life Plan) faced, access to capital and access and maintenance of dependable and qualified labor are the two most challenging. COVID shaved occupancies rather substantially. Pre-pandemic, as … Read more

Friday Feature: Senior Living Investment Outlook

TGIF! On a calendar year basis, we are into the home stretch for 2023. It’s generally about now that I start looking at how 2024 is shaping up. What trends are there to watch? What do markets look like now, socially and economically? What does policy and politics tell us about the year to come? … Read more

SNF Staffing, Mandates, and More

Seema Verma, former CMS head, spoke out yesterday regarding the proposed staffing mandate (hours and type of staff, per resident per day) proposed rule, indicating her opinion that the approach was flawed. A recap article on her comments is here: https://www.mcknights.com/news/former-cms-chief-verma-regulators-over-their-skis-with-staffing-mandate/?utm_source=newsletter&utm_medium=email&utm_campaign=NWLTR_MLT_DAILYUPDATE_110223&hmEmail=IjP1GPaY%2BJ2uvsLxTJ79bVeRWY7ycbnr&sha256email=aa4cb7c695037c31a216b9562788596b6fcd012145d566f31440b6fcd139c8a9 Regular readers know that I have covered various topics on healthcare staffing, particularly as … Read more

MedPAC and Medicare Advantage

In yesterday’s post, Mish-Mash Monday, in the section about the House Budget Committee’s Health Care Task Force, I offered some commentary regarding MedPAC (Medicare Payment Advisory Commission) and Medicare Advantage plans. I also included a letter from the senior living trade association LeadingAge to the Congressional task force that references MedPAC’s concerns regarding Medicare Advantage … Read more