Healthcare, Senior Living, Economics
A couple of weeks ago, I wrote a post covering the Home Health PPS Final Rule for 2014. As I was writing that post, I simultaneously reviewed the Gentiva/Harden deal plus the recent quarterly earnings of Amedisys and Almost Family (plus their acquisition of SunCrest HealthCare). The earnings reports plus the analytics from these two … Read more
With all the news and among the conjecture, punditry and analysis that fits any twenty-four hour news cycle, I wondered with a few colleagues the other day, how predictable the events current with Obamacare were. Americans being who we are, our collective political memories and policy memories are short. I too, often find even the recent … Read more
Last Friday, CMS issued its final rules for 2014 Home Health PPS. As is typical within these final rules, earlier proposals are clarified and additional direction for the future becomes clearer. In this case, most people who follow the Home Health industry trends will find the continuation of prior year themes; rate reduction, episodic rebasing, additional reportable quality … Read more
A topic that I receive queries about from time to time concerns the payment practices of Medicare Advantage (MA) plans as the same relates to traditional Med A coverage under the PPS system. Recently (earlier this year and then again in October, CMS issued some fairly vague guidance to the MA world regarding a requirement … Read more
Most of my readers know by now that I am an economist by training and formal education. My clients know this as well. The net result is that I’ve been queried, almost to death as of late, as to what this current round of Washington folly is really all about. Is it about the ACA? … Read more
An issue that continues to confound the hospital and SNF industry is the growing use and thus, referral and coverage (Medicare) ramifications of observation stays. Fundamentally, and observation stay by current definition is a non-inpatient stay – an extended residence in an outpatient status. Truly, this a bifurcated problem or issue; hospitals wishing to avoid … Read more
This is the second post of a four-part series on the status and implications of the continuing roll-forward/roll-out of the Affordable Care Act (aka Obamacare). In this post, the context is the implications for providers, given the evolving state of the ACA and some of the current uncertainty of its future. Important to note: Affirmatively, the … Read more
A number of my regular readers and clients routinely ask for my thoughts/analysis on where the Reform Act/Affordable Care Act/Obamacare is at, particularly in-light of the recent one-year delay in the employer mandate. Given the complexity of this subject and the scope of the overall law, a single post won’t cover the subject adequately. In compiling … Read more
As a wrap to my two previous articles regarding recent fraud and False Claims Act suits and issues in the hospice industry, a concluding piece is warranted. As I have written before, the fraud issues and cases in the Hospice industry divide (though not equally) between the providers committing the fraud and an inferior Medicare Hospice Benefit … Read more
On May 5, the U.S. Department of Justice released its most recent complaint (legal suit filed in Federal court) against Chemed, the corporate parent of Vitas. The complaint is a False Claims Act suit. Briefly for the uninitiated, a False Claims Act suit alleges that the Medicare provider knowingly (or unknowingly but once discovered, did … Read more