Healthcare, Senior Living, Economics
In 2021, Congress passed the Consolidated Appropriations Act of 2021. Within the Act, a new Medicare provider was created – the Rural Emergency Hospital (REH). The final rule is available here: Rural Emergency Hospital Final Rule REHs were created to improve and increase, access to emergency services and ideally, expanded outpatient services in rural areas. Starting … Read more
Two articles in my email caught my attention to start the week. Both have to do with SNF closure risks, one regarding rural facilities and the other regarding staffing challenges. Interesting enough, both cross the same issues for closure, approached however, somewhat differently. I’ve written about this subject for years now yet, attention has only become acute … Read more
TGIF! The U.S. is aging. Its median age is 37.7, just behind China’s median age of 37.9. Comparatively, the U.S. would be considered young in relationship to Japan where the median age is 48.4. While it is true that the Japanese have a longer life expectancy than the average American (84.6 years vs. 77.29 years), … Read more
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
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
It was only a matter of time before litigation came forward regarding the use of Artificial Intelligence (AI) in primarily, Medicare Advantage plans, where coverage denials/determinations are at issue. This week, a class action suit dropped in the U.S. Circuit Court of Western Kentucky against Humana. A link to the suit is here: https://www.scribd.com/document/692182281/Humana-AI-NaviHealth-MA-lawsuit In … Read more
Happy Hump Day! Only 12 more shopping days until Christmas! In mid-November, CMS issued a final rule titled: “Medicare and Medicaid Programs; Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers’ Disclosure of Private Equity Companies and Real Estate Investment Trusts“. The final rule is … Read more
Yesterday I wrote about MedPAC’s rate recommendations for SNFs for FY 2025. Recall, MedPAC makes these recommendations annually, assuming the full commission votes (in January 2024) for the recommendations as released by draft. The final recommendations go to Congress. Yesterday’s post was the “draft” position for SNFs. Today, I’m including summaries for Home Health, Hospice, … Read more
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
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