Healthcare, Senior Living, Economics
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
After CMS nixed the mandatory expansion provisions for Bundled Payments and reduced the metro areas participating in CJR (joint replacement), the prospects for post-acute provider involvement in non-fee-for-service initiatives (payments and incentives based on disease states and care episodes) went in to limbo. With a fair amount of excitement and trepidation building on the part of the … Read more
I’m not sure how many of my readers are following the subject and CMS stance/policy on interoperability among providers but the concepts and resultant debate are rather interesting. I am trying to encourage as many clients and readers to tune-in on this subject as the implications are sweeping – positively and negatively. Interoperability in this … Read more
In a memo set for release today, CMS is proposing to reintroduce pre-payment review (with a twist) for Home Health claims. The memo version is here: HHA Pre Payment Recall, CMS first introduced pre-payment review in August 2016, starting in Illinois. The process required agencies to submit claim-related data BEFORE receiving final payment or face an … Read more
Last year 2017, was a bit of a “downer” in terms of mergers/acquisitions in the home health and hospice industry. Though 2017 was fluid for hospital and health system activity, the home health and hospice sectors lagged a bit. Some of the lag was due to capacity concerns in so much that health system mergers, if … Read more
Last Friday, CMS released the contents of its annual proposed rule updating the SNF PPS plus (as always), fine tuning certain related programmatic elements. Final Federal Register Publication is set for May 8. (Anyone wishing the PDF version may download it from the Reports and Other Documents page on this site or access it here … Read more
As 2017 closed, a number of projects kept me busy right up to the Christmas holiday. Among these projects was a focus on the SNF industry current and its fortunes going forward, principally driven by clients in the investment industry. With REIT troubles, portfolio defaults on the part of HCR and Consulate, Sabra divesting Genesis facilities … Read more