Friday Feature: Healthcare Economics Update

TGIF! A report I get and enjoy comes from Altarum (a non-profit consulting organization) looking at various economic data elements with regard to healthcare spending across a number of metrics (percent of GDP, time series growth, etc.). Granted, the report is a bit “wonky” but given what I do for a living, “wonky” is kind … Read more

Wednesday Feature -The Soaring Price of Care: How Retirement Costs are Reaching New Heights

Happy Hump Day! Today’s post is shorter than normal as I have to attend a funeral on behalf of one of my partners (also a very close, close friend). His mom passed away recently, and the service is today. She was a wonderful woman, mom, wife, and grandmother and she will be missed by all who knew … Read more

Wednesday Feature: Neglected, Uninspected – Senate Aging Committee Report on SNF Surveys

Happy Hump Day! Yesterday I wrote about the OIG’s (Department of Health and Human Services) report and focus on CMS’ oversight of state survey agencies. The impetus behind this focus no doubt comes from the U.S. Senate Special Committee on Aging’s investigation into nursing home survey activities at the state level. The report is available … Read more

OIG: CMS Should Take Action Against States with Poor SNF Survey Performance

Last week, the U.S. Department of Health and Human Services Office of the Inspector General (OIG), issued a report regarding the performance of contracted state agencies with respect to nursing home (SNF) compliance surveys. CMS contracts with state agencies, typically state departments of health or divisions thereto, to perform compliance/regulatory activities (surveys) in nursing homes. The report … Read more

Rural Hospital Program: Extra Cash for Emergency and Outpatient Services Stuck in Neutral

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

SNF Closure Risks Increasing

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

Friday Feature: The Economic Impact in Aging Countries

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

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

Humana, United Health: Class Action Suits over AI use in Coverage Determination

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