As providers continue to stare down the October 1 implementation of a new Medicare payment model for nursing homes, specialization remains at the top of many operators’ to-do lists — with respiratory therapy potentially emerging as a key revenue source. Because the Patient-Driven Payment Model (PDPM) matches reimbursements with resident acuity, operators have looked to […]
With the Medicare reimbursement overhaul taking place in a few short months, skilled nursing facilities — ideally — are moving into the last stages of preparation and training for staff and workflow procedures. But according to post-acute care partnership strategist Mike Wetula of therapy company TMC, SNFs can’t ignore their referral partners in the process. […]
In a rush to find savings amid a changing payment landscape, hospitals have turned to the reduction in institutional post-acute care, especially in skilled nursing facilities. But that determination to secure savings could have unintended consequences for patients, their families, and SNFs, according to a perspective article published Wednesday in the New England Journal of […]
As resident acuities rise and reimbursements more closely link up with resident results, boosting physician services in skilled nursing facilities has emerged as a potential strategy to improve both outcomes and income — whether it’s through in-person visits or telehealth. In the northwest corner of Washington state, Swenson Healthcare has been taking something of a […]
The number of skilled nursing providers interested in becoming insurers has grown for the past several months. Now hard numbers show just how great that interest is. Special needs plans are a category within Medicare Advantage (MA) that provide a common framework for the plans that serve special-needs beneficiaries, while also expanding beneficiary choice and […]
With the Medicare Part A reimbursement overhaul taking effect in just a few months, skilled nursing providers across the country are in countdown mode. But the clock is moving at different paces for different providers, several experts said. Some SNFs began their analysis and preparations months ago; others are barely getting started. That’s led to […]
The Centers for Medicare & Medicaid Services overturned a ban on skilled nursing operators using pre-dispute arbitration agreements with their residents in a final rule issued July 16, and a range of lawmakers reacted throughout the week. The ban on arbitration agreements in long-term care was implemented by the Obama administration in 2016, to strong […]
The Centers for Medicare & Medicaid Services’ (CMS) overhaul of the Medicare Shared Savings Program is paying off in the form of greater accountability and more risk-taking, CMS administrator Seema Verma wrote in a blog post published Wednesday in Health Affairs. The post came as part of an announcement about accountable care organization (ACO) participation […]
Skilled nursing facilities could see relief from regulatory burdens if a proposed rule from the Centers for Medicare & Medicaid Services (CMS) takes effect, and according to the agency, it could lead to millions in savings. Specifically, the rule would overhaul multiple requirements and delay the implementation of regulations related to the Quality Assurance and […]
The refrain has been nearly constant in the skilled nursing space: In order to win precious referrals in new payment models, operators need to woo hospital partners with strong data on outcomes. But a new study says all that effort might not matter much at all. A team of researchers could identify no significant changes […]
The federal government on Tuesday finalized a rule that allows skilled nursing operators to use arbitration agreements with their residents, while also proposing a new rule to reduce paperwork burdens that would delay certain aspects of the Requirements of Participation. The Centers for Medicare & Medicaid Services (CMS) struck something of a compromise with the […]
Multiple analyses have demonstrated that accountable care organizations (ACOs) reduce the use of skilled nursing facilities and other institutional post-acute care settings, and a new study may have identified a subtle culprit for the trend: specialist physicians. ACOs with the highest proportion of specialist visits had demonstrably lower rates of hospital admissions, skilled nursing encounters, […]
Adam Boehler will leave his position as the chief of the federal government’s top incubator for new payment models after an appointment to another office. President Trump late Wednesday nominated Boehler — who has served as director of the Center for Medicare & Medicaid Innovation (CMMI) since April 2018 — to become the CEO of […]
The Medicare Value-Based Purchasing (VBP) program, which distributed its first round of incentives and penalties on October 1 of last year, has a goal of rewarding high-quality skilled nursing care by tying Medicare payments to performance. In that round, almost three-quarters of SNFs saw penalties. And a new study published this month in the journal […]
The federal government on Wednesday unveiled a new proposed payment model for certain kidney-related conditions, and several providers in the space say it could have serious potential for skilled nursing operators. Under the proposed End-Stage Renal Disease (ESRD) Treatment Choices (ETC) model, Medicare would expand coverage of care for kidney diseases and offer financial incentives […]
Under the Patient-Driven Payment Model (PDPM), reimbursement for Medicare Part A patients in skilled nursing facilities will be driven by patient condition, rather than by therapy minutes provided to that patient. It’s a change that the industry has hailed as an opportunity to receive financial credit for the care that they’re already providing, but they […]
Nursing home star ratings have been under the national microscope for a good part of the spring and summer, and a health care advocacy organization joined the fray last week by suggesting that federal regulators might need to ditch the quality measure component entirely. As currently structured, ratings on the Centers for Medicare & Medicaid […]
One of the federal government’s key bundled payment programs has resulted in per-episode spending reductions of nearly $1,000, primarily by cutting lengths of stay in nursing homes and other institutional sites of care — but researchers still aren’t sure if the program saves Medicare money on the whole. During the first two years of the […]
While governments and payers increasingly incentivize the provision of long-term care at home instead of in skilled nursing facilities, data about outcomes remains few and far between — with one group of researchers finding that some high-acuity patients fare worse in the community setting. Based on 2012 claims data, a team from the University of […]
A False Claims Act (FCA) case against HCR ManorCare’s Heartland hospice affiliates was dismissed with prejudice on Wednesday by Judge James Carr of the U.S. District Court for the Northern District of Ohio. The government had previously declined to intervene in the qui tam complaint made by Kathi Holloway, who worked as a regional hospice consultant […]
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