JAMA Study: Private Equity Ownership and Hospital Outcomes

Happy 2024! I trust everyone had a blessed and happy holiday season and rang in the New Year with joy and optimism. Across the last two months of 2023, JAMA (Journal of American Medical Association) has published two studies on private equity ownership in healthcare, specifically in hospitals and SNFs. Not to accuse JAMA of having … Read more

Washington Post and Assisted Living (not so good) News

Yesterday, a story in the Washington Post highlighted a series of wandering cases where residents from an Assisted Living or Memory Care facility wandered and were later, found dead. Industry insiders knew this story was coming and yesterday, it dropped. In many ways, it is eerily similar to a PBS story a decade ago around poor care/neglect … Read more

MedPAC Recommends 3% Rate Cut for SNFs – 2025

The Medicare Payment Advisory Commission is (likely) recommending to Congress a series of post-acute rate reductions (Medicare, Fee-for-Service) for federal fiscal year 2025 (beginning October 1, 2024, for most programs, January 1, 2025, for Home Health Agencies). Specifically, the MedPAC recommendations are as follows. Reduce the 2025 payment rate for home health agencies by 7%. … Read more

Friday Feature: Affordability of Senior Living and Services

TGIF and Happy Hanukkah (to my Jewish colleagues and friends)! A major concern as the demographic in the U.S. ages is senior housing and services affordability. The expanding cohort of seniors in terms of real purchasing power, is not as financially fit as prior generations. The Baby Boomers for example, while well paid in their … Read more

Medicaid: HCBS and Eligibility Updates

I follow Medicaid but don’t often get many inquiries around Medicaid policy or requests for articles in this subject area. Medicaid, however, is very important for providers, especially post-acute and senior living, as it is typically, a significant if not majority payer. During COVID and the public health emergency, Medicaid policy and CMS enacted requirements … Read more

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

Compliance Update: Fraud and Abuse

A complex area for providers, especially with respect to their compliance programs, are the concepts of fraud and abuse. Central to current requirements for compliance programs, all post-acute providers are REQUIRED to have compliance programs that, Include policies and procedures to define, test for, and mitigate any issues pertaining to fraud and abuse. In this … 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

Rising Health Care Costs – A Serious Issue, Election Implications?

Long time readers/followers know that I from time to time, address health care costs. I follow economics generally and write about the same, especially when there are intersectional issues to address. As we are heading into a presidential election cycle (we are in the early innings) and, issues like health care costs in this country … 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