Healthcare, Senior Living, Economics
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
Yesterday, CMS began posting the first elements from the Quality Reporting Program. There are five elements that contain data, compared to the national average. Percent of residents developing new or worsening pressure injuries Percent of residents experiencing one or more falls with major injury Percent of residents who had a functional assessment on admission and the … Read more
In the 2019 OPPS (outpatient PPS) proposed rule, CMS included a site neutral payment provision. With the comment period closed, the lobbying (against) fierce, it will be interesting to see where CMS lands in terms of the final OPPS rule – maintain, change, or abate. The one thing that is for certain, regardless of the … Read more
Beginning yesterday, I’ve been following the news regarding CMS’ annual issuance of Final PPS rules for providers. Of greatest interest is the SNF Final Rule as it includes a completely new payment system, departing from the RUGS IV, therapy-centric system currently in-place. I’ve read through the Final Rule (all 424 mind-numbing pages) and summarized what SNFs … Read more
Yesterday I wrote a quick post regarding the news that CMS was about to issue the SNF Final Rule for Fiscal Year 2019. Today, the text is available. Official publication in the Federal Register is set for August 8th. Readers may access the text here: SNF 2019 Final Rule I will have analysis and more … Read more