Healthcare, Senior Living, Economics
Following up from my last post regarding staffing and litigation risks, this post concentrates on “what we know” and “what we can control”. For example, what we know is that there simply is not enough staff (clinical and even non-clinical) to fill a provider’s vacant positions. The world in general knows this and the press, … Read more
One quarter (three months and change) down and PDPM appears to be mostly positive for SNFs. CMS is reporting a higher average per diem payment level than under RUGs. Despite some added coding complexity, paperwork burdens are down for providers (two MDS’ during most stays now vs. many under RUGs). Anecdotally, the industry is seeing … Read more
The beautiful, fascinating thing about health policy in the U.S. is its cycle of evolution. It evolves, sometimes slowly and other times quickly but always, in a progressive (not in the political sense) direction. Providers today can be lulled to sleep (quickly) by the vacuum drone of big policy lectures, webinars, etc., easily thinking for … Read more
In nearly all provider segments of health care, revenue maximization and integrity are directly tied to compliance and quality ratings. In home health, submission of quality data via the OASIS (known as HH CAHPS) is required. Agencies that fail to submit the required data experience reimbursement reductions of 2%. For SNFs, reporting of QRP data … Read more
I spend a good (ok, large) amount of time working with non-profit and privately held health care, post-acute and seniors housing organizations. Nearly all of my work is at the C-level and above and frankly, my career as an executive was there as well (25 plus years). Boards/governance bodies play a key role in the success and/or failure of … Read more
About ten days ago, I wrote a piece regarding the negative impacts providers can expect (and receive) when quality of care and service combined with vigilance on compliance are not primary in and across their organizations. All too often, I hear companies and organizations that I work with, say they are committed to quality but by deeds, the evidence is … Read more
A number of interesting information drops occurred this past week or so reminding me that from time to time, the obvious isn’t always so obvious. The seniors housing and skilled care industry today is going through a rocky patch. A solid half of the SNF industry is severely hurting or struggling mightily due to Med … Read more
While I was in Philadelphia speaking at LeadingAge’s annual conference, CMS released its 2019 Home Health Final Rule. As I wrote in an earlier post regarding the proposed rule, the topic of interest was/is a new payment model – PDGM. As has been the case across the post-acute industry, CMS is advancing case-mix models crafted around … Read more
In early October, I wrote an article regarding CMS 2019 OPPS (outpatient PPS) proposed rule, specifically regarding site neutral payments. The purpose of the article was to address the site neutrality trend that CMS is on, streamlining payments to reduced location of care disparities for the same care services. Succinctly, if the care provided is … Read more
A week from today, I am conducting a webinar on reducing/avoiding unnecessary rehospitalizations. With SNFs just experiencing the VBP impact (Medicare incentive or reduction) starting October 1, this event is extremely timely. I’ll cover the health policy and reimbursement implications regarding rehospitalizations plus new QRP and QM updates. I’ll also touch on PDPM implications. Some great … Read more