Healthcare, Senior Living, Economics
The U.S. spends more than any other world nation on healthcare – gross dollars and per capita. The systemic growth of spending continues at rate beyond inflation, spurred-on by an aging demographic and chronic diseases like diabetes and obesity. Cost growth in programs like Medicare is rampant but then again, so is fraud. Federal spending … Read more
The Accreditation Commission for Health Care, Inc. (ACHC) has launched two new specialty credentials for organizations providing home care and/or hospice. These programs are in line with the Age-Friendly Health Systems (Care) programs and initiatives started by The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and … Read more
Fitch Ratings has completed updates to its ratings criteria for not-for-profit continuing care retirement/life plan communities (CCRCs), enhancing the reflection of the risk profile for these rated entities. These changes come after a period of commentary on a draft released earlier this spring. The criteria modifications aim to more accurately represent the distinct risks associated … Read more
The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute care providers. Transforming Episode Accountability Model (TEAM) | CMS The Transforming Episode Accountability Model (TEAM) is set to be a … Read more
The healthcare sector has experienced another quarter of record-high distress levels, as indicated by the volume of bankruptcy filings, with the senior living and care sector at the forefront. This bankruptcy trend for senior living remains alarming. In January, I took a look at 2023 bankruptcy levels, the worse year in decades. That post is … Read more
According to a Wall Street Journal article from August 4, Medicare Advantage plans are using home nurse visits to identify possible or questionable disease states/conditions (so called, phantom diseases) via screenings. These diagnoses then turn into what appears to be, possible events of fraud via additional reimbursement tied to these new-found conditions. Exclusive | The … Read more
Under the Final 2025 (PPS) rule released last Wednesday, nursing homes are set to receive a 4.2% pay increase in Medicare Part A. Additionally, the facilities will encounter a stricter fines system, with civil monetary penalties being applicable in more situations. The Final Rule is available here: SNF Final Rule 2025 In April I wrote … Read more
According to a recent JAMA (Journal of the American Medical Association) research letter private equity firms invested $505 billion in healthcare acquisitions from 2018 to 2023. These financial infusions can enhance resources for care. However, these firms have occasionally sold the land and buildings of acquired hospitals, using the proceeds to repay investors and leaving … Read more
Not too long ago, I wrote a post regarding federal legislative activity seeking to impose regulation on Private Equity firms investing in senior living organizations (SNFs, home health, hospice, assisted living). That post is available here: https://rhislop3.com/2024/06/13/private-equity-investment-in-nursing-home-sector-generates-regulatory-scrutiny/ That post focused on a bill known as the Corporate Crimes Against Health Care Act of 2024 aims … Read more
As of the latest demographic data from Pew Research, 62 million people in the U.S. are age 65 or older Number of people 100 and older is growing in US and around the world | Pew Research Center Presently, there are approximately 7,500 licensed geriatricians in the U.S., or 1 per every 8,267 seniors. Despite … Read more