Healthcare, Senior Living, Economics
When I got married to my wife and business partner (the partner came after), part of our honeymoon was spent in Las Vegas. While there, we caught Penn and Teller’s Vegas show and it was AWESOME! I love magic and in particular, the kind that is up close and personal. The trade term now seems … Read more
A couple of weeks ago, on February 22nd. the Department of Justice issued its annual statement regarding False Claims Act activity in FY 2023 (federal fiscal years run 10/1 to 9/30). “Settlements and judgments under the False Claims Act exceeded $2.68 billion in the fiscal year ending Sept. 30, 2023. The government and whistleblowers were … Read more
Yesterday, the American Health Care Association and the National Center for Assisted Living plus the National Assocation of ACOs released a white paper that includes a set of recommendations for CMS, designed to increase the participation of long term and post-acute care (LTPAC) providers in accountable care organizations (ACOs). The white paper is available here: AHCA … Read more
Among the many healthcare sectors I follow, rural healthcare has become my favorite. Oddly enough, it’s not because of the policy issues that exist, though it should be. It is because it is an overlooked sector and one that has a real risk of collapse. Last summer (2023) I wrote a post about the plight … Read more
Late last week, I ran across a number of news posts regarding a proposed class action lawsuit against the hospital/health system giant Advocate Aurora, alleging that the organization used its market mass to limit competition and in return, impose excessively high prices on commercial health plans and their insureds. The suit was filed in Wisconsin (where … Read more
In 2023, regulators re-instituted audits of facilities for inappropriate diagnoses of schizophrenia (justification for anti-psychotic use), plus a five-claim audit of every nursing home. The purpose of the audit was to address a long-standing concern that inappropriate coding was driving higher Medicare reimbursement under PDPM, despite documentation in patient records, not substantiating the level of care … Read more
Senior Housing News and Lument conducted a survey (November of 2023) of senior living organizations and executives regarding their outlook for 2024. They consolidated the responses into a report. That report is available here: 2024-shn-lument-outlooksurveyreport-vf.original The highlights from the report are below. The general consensus of respondents was a positive outlook (87%) for 2024, buffered mostly … Read more
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
Over the years I have written many articles about the cost of healthcare and in particular, the cost of senior living and senior healthcare. As the population ages, the demand for senior living and care expands. Per the U.S. Census Bureau, the U.S. population age 65 and over grew nearly five times faster than the … Read more
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