Healthcare, Senior Living, Economics
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
By popular request, I’ve created a new feature to this site to cover issues and topics “in brief” that I am watching or in some cases, directly tangential to by engagement. Weekly, my inbox is awash in “what have you heard?”, “are you seeing this?”, “what’s going on with?”, etc., type questions. I do try to answer them … Read more
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
Periodically, the source for a post on this site is the accumulation of thematically condensed questions that I receive regularly and with frequency; what I now call the “buzz”. While the “buzz” for me is fairly constant across the post-acute/seniors housing industry, the pitch does vary, sometimes daily but most often, weekly. I guess it just … Read more
In a move that most industry watchers including myself believed was unlikely to occur, CMS decided to reverse course on a proposal to require SNFs to have separate relationships for dispensing and consulting pharmacies/pharmacists. CMS publicized its decision yesterday. About a month ago in a post I wrote regarding post-acute trends (http://wp.me/ptUlY-aO ), I indicated that … Read more
In my recent work and across recent discussions, phone conferences, etc., I’ve encountered a thematic trend; a circle of issues or as in reference to geese, perhaps a gaggle. Doing a bit of research and sifting through notes written over the past few weeks, here is what is trending. Pharmacy: In October of last year, … Read more
Literally fresh off of a significant rate adjustment/reduction in October (2011), Medpac (the Medicare Payment Advisory Commission) releases a recommendation for complete SNF payment overhaul. In their assessment of the SNF payment system under Medicare, Medpac concludes the following; Medicare payments to SNFs represent 23% of all revenues. Medicare (payer) as a share of SNF patient … Read more
Last week I published a post regarding Medicare fraud that is occurring in the post-acute industry. The post is available at http://wp.me/ptUlY-ak . At the end, I indicated that I would provide a follow-up post; a closer piece more succinct on why the fraud trend is heating up and what the drivers for this trend are. In … Read more
What never ceases to amaze me is the amount of post-news discussion that occurs when certain issues rise to the front-page (or near the front page). Seemingly, industry side-liners awaken and look in disbelief that one major provider organization or another is again, embroiled in some OIG investigation, lawsuit or official inquiry concerning their Medicare … Read more
The failure of the Super Committee to achieve any measure of “go forward” spending reform left unresolved, a whole host of Medicare program spending messes, many of which will rear their ugly heads come January 1. While many lament the Committee’s failure to resolve equitably, what is set to become automatic cuts, the truth of the matter … Read more