Tag: Money

Home Health

DOJ Recovers $2.9 Billion in Fraud in 2024

The Department of Justice (DOJ) announced that the agency recovered $2.9 billion in resolutions to federal False Claims Act allegations for 2024 (fiscal year ending September 30). This is a slight increase from the historic…

Life Plan/CCRC

CCRCs (Life Plan): Econ Data in Marketing?

In a time of constantly changing markets, grasping economic indicators can give marketers a significant advantage. These indicators are statistical/data measures that provide a look into the economy’s present and future conditions, serving as potent…

Health Policy and Economics

Doc Payment Fix in the Works?

Here’s an oldie but a goodie for today. The House Ways and Means Committee is reportedly considering a markup of legislation this month that would revamp Medicare’s physician payment system. This move could increase the…

Health Policy and Economics

The Debate: Policy that Should be Discussed

Tonight’s presidential debate should be policy focused but likely, won’t be or won’t be with sufficient detail. There are a ton of policy issues that should be discussed. Healthcare policy, in my opinion, should be…

Health Policy and Economics

Check: Medicare Advantage Coverage Issues

Late last year, CMS proposed a final rule to address the issue of coverage denials or service denials via prior authorization on behalf of Medicare Advantage Plans. Between providers and patients, coverage issues have significantly…

Health Policy and Economics

Eighteen CCRCs Impacted by Fitch Ratings Update

Last week I wrote about Fitch Ratings updates to their non-profit CCRC rating criteria. The expectation with the changes was that twelve percent of the rated CCRCs could be subject to Under Criteria Observation (UCO)….

Life Plan/CCRC

Fitch Non-Profit CCRC Ratings Update

Fitch Ratings has completed updates to its ratings criteria for not-for-profit continuing care retirement/life plan communities (CCRCs), enhancing the reflection of the risk profile for these rated entities. These changes come after a period of…

Health Policy and Economics

Phantom Diseases and Medicare Advantage Fraud

According to a Wall Street Journal article from August 4, Medicare Advantage plans are using home nurse visits to identify possible or questionable disease states/conditions (so called, phantom diseases) via screenings. These diagnoses then turn…

Policy and Politics - Federal

Final 2025 SNF Rule – Rate Increase, More Fines

Under the Final 2025 (PPS) rule released last Wednesday, nursing homes are set to receive a 4.2% pay increase in Medicare Part A. Additionally, the facilities will encounter a stricter fines system, with civil monetary…

Health Policy and Economics

Private Equity and Hospital Assets

According to a recent JAMA (Journal of the American Medical Association) research letter private equity firms invested $505 billion in healthcare acquisitions from 2018 to 2023. These financial infusions can enhance resources for care. However,…

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Reg

Healthcare executive, consultant, and author covering post-acute care, senior living, and the economics behind both - for 30+ years.

The Weekly Briffing

No noise - just what changed in healthcare policy and economics, and why it matters to your operation.