CMS Offers Fix to Medicare Advantage Denials

An issue that has been tied to AI (artificial intelligence) and specifically, to Medicare Advantage plans, involves coverage denials. I wrote about this in a post earlier this year at https://rhislop3.com/2023/05/01/medicare-advantage-part-d-final-rule/ Coverage denials have been a fairly hot topic around Medicare Advantage plans. The core of the issue is that Medicare Advantage plans are required … Read more

Wednesday Feature: A Bit of Economic Nostalgia

Happy Hump Day! I was going back through some historic stuff and I landed in 2010. The year 2010 was, after further review, eerily similar to right now, economically speaking. Sadly, not much has changed in terms of health policy and the economic state of healthcare. In 2010, the economy was choppy, recovering or trying … Read more

Rising Health Care Costs – A Serious Issue, Election Implications?

Long time readers/followers know that I from time to time, address health care costs. I follow economics generally and write about the same, especially when there are intersectional issues to address. As we are heading into a presidential election cycle (we are in the early innings) and, issues like health care costs in this country … Read more

SNF Staffing, Mandates, and More

Seema Verma, former CMS head, spoke out yesterday regarding the proposed staffing mandate (hours and type of staff, per resident per day) proposed rule, indicating her opinion that the approach was flawed. A recap article on her comments is here: https://www.mcknights.com/news/former-cms-chief-verma-regulators-over-their-skis-with-staffing-mandate/?utm_source=newsletter&utm_medium=email&utm_campaign=NWLTR_MLT_DAILYUPDATE_110223&hmEmail=IjP1GPaY%2BJ2uvsLxTJ79bVeRWY7ycbnr&sha256email=aa4cb7c695037c31a216b9562788596b6fcd012145d566f31440b6fcd139c8a9 Regular readers know that I have covered various topics on healthcare staffing, particularly as … Read more

MedPAC and Medicare Advantage

In yesterday’s post, Mish-Mash Monday, in the section about the House Budget Committee’s Health Care Task Force, I offered some commentary regarding MedPAC (Medicare Payment Advisory Commission) and Medicare Advantage plans. I also included a letter from the senior living trade association LeadingAge to the Congressional task force that references MedPAC’s concerns regarding Medicare Advantage … Read more

Mish-Mash Monday

A new week and lots of data/info. coming on a variety of fronts. Today’s post is less about one thing and more about a few things, a bit of smorgasbord to start the week. State by State SNF Data/CLA: Back at the start of the month, I wrote a post on the state of the SNF … Read more

Twofer Thursday: Staffing Litigation and a Bit More on Medicare Advantage Plans

Today’s post is a bit of a hybrid. I’m trying to keep up with a bunch of things ranging from policy to economics (Jerome Powell speech today) to some work stuff so I’m combining two things today that probably, deserve a bit more dissection, but this will do for now. Plus, I’m hopeful that tomorrow … Read more

Medicare Advantage – Status Update

Medicare Advantage plans or Medicare Part C and D plans continue to grow in popularity. I’ve written a number of posts on various Medicare Advantage topics, of late, coverage issues and denials, particularly for post-acute care stays. A recent post on that topic is here: https://wp.me/ptUlY-wI Medicare Advantage plans (Part C plans) include Parts A, … Read more

Value-Based Care: Why it Matters, or Should, for Post-Acute Providers

Value-Based Care is kind of a vogue term, one that I encounter quite often. I also have used it when speaking or writing and know most people have no idea what it means or how it can be developed and/or applied. Value-based care is not a new concept. Medicare tried a foray into it back … Read more

How Much is Enough? Deficits, Debt, and a Look Into the Future

Lately, I’ve gotten quite a bit of 70s (1970s) deja vu. Yes, I’m old enough to vividly remember the 70s as I crossed the decade as a teenager, graduating high school and almost, college. If one has my memories, the 70s were pretty turbulent times, analogous to now. In 1973, Israel and the Arab (Egypt … Read more