With October 1 a few short months away, skilled nursing providers should be well into their preparations for the Patient-Driven Payment Model (PDPM), the overhaul of Medicare Part A reimbursement that’s set to take effect at the start of the new fiscal year. The new requirements include a variety of new possibilities for payment, since […]
Category: Medicare
A bipartisan pair of U.S. representatives late last week submitted legislation that would potentially bring new quality measures to the federal Value-Based Purchasing (VBP) program. HR 3406, introduced in the House of Representatives last Friday, would empower the Centers for Medicare & Medicaid Services (CMS) to roll out up to 10 additional metrics for inclusion […]
With the U.S. health care system lumbering toward value-based care and grappling with how to match payments with outcomes, accountable care organizations (ACOs) have come under the spotlight. But despite conflicting reports about their capacity to produce savings and improve care, one operator tells Skilled Nursing News that there is no doubt about one thing: […]
The siphoning of residents from skilled nursing facilities into the home health space remains a troubling trend for institutional operators, and an executive at one of the nation’s largest health systems sees nothing but acceleration ahead. “There’s almost nothing that won’t eventually move to the home,” Scott Powder, chief strategy officer of Advocate Aurora Health, […]
Accountable care organizations (ACOs) have generated a slight reduction in overall Medicare spending, a new analysis found — adding another viewpoint to a growing and occasionally contradictory body of research. The Medicare Payment Advisory Commission (MedPAC) determined that ACOs led to a 1 to 2 percentage-point drop in Medicare outlays between 2013 and 2016, though […]
For the second time in less than a month, a national provider of dialysis services has teamed up with a major skilled nursing operator looking to expand its specialty capabilities — with an eye toward rolling out the program in a significant chunk of its buildings. Signature HealthCARE, which has 115 skilled nursing facilities spread […]
A top government watchdog and advocate for Medicare payment reform on Friday accused post-acute care providers of using mandatory functional assessments to boost payments instead of accurately recording patient needs. As part of its sprawling annual report to Congress on reimbursement issues, the Medicare Payment Advisory Commission (MedPAC) probed the differences between individual residents’ functional […]
Risk-sharing has loomed large in health care reform efforts over the last decade, and the new Medicare payment model for skilled nursing facilities could open up additional avenues for operators to take control — along with pointed questions from partners along the spectrum. The Patient-Driven Payment Model (PDPM) marks a step toward a long-teased site-neutral […]
The federal government’s top health care watchdog on Wednesday released a new report accusing the Centers for Medicare & Medicaid Services (CMS) of not doing enough to monitor and punish elder abuse in nursing homes and other settings. The Department of Health and Human Services (HHS) determined that CMS could perform detailed analyses of diagnosis […]
In the competitive world of short-term rehab, success depends on both who and what you know — and, by extension, how you tell your individual building’s story to the people whose opinions matter the most. The Medicare-focused building has been hailed as the future of skilled nursing and questioned as a difficult-to-achieve pipe dream, but […]
Adding behavioral health services has frequently been floated as a way that nursing homes can diversify their offerings and attract new residents — particularly as demand for the treatment of depression and other mental health issues continues to grow among older Americans. But a significant swath of operators report persistent challenges in caring for residents […]
The market will still need to determine whether the new Medicare reimbursement structure for nursing homes will be a net positive or negative for the industry, but at least one insider says buyers and sellers in the space aren’t optimistic enough. Current prices for skilled nursing facilities don’t typically account for the potential of cost […]
In a reimbursement landscape where hospitals increasingly look to cut nursing homes out of the continuum of care entirely, a recent study found that it’s possible to predict “with good accuracy and clinical usability” which patients will end up being discharged to a skilled nursing facility. The index — which was developed by researchers from […]
The skilled nursing industry has — with good reason — thrown much of its energy and focus onto the challenges of the Medicare reimbursement overhaul taking effect on October 1 of this year. But according to one prominent industry leader, the challenges of Medicaid pose a far greater threat to providers — particularly as the […]
The percentage of residents discharged from hospitals to skilled nursing facilities dropped from 45% to 26% in just three years amid the implementation of a mandatory bundled payment program in New Jersey, a new study found. Since April 2016, 38 hospitals in the Garden State have been required to participate in the Comprehensive Care for […]
The new Medicare model for skilled nursing facilities more closely links reimbursements with resident conditions — and making sure that facilities completely document those conditions will soon be an essential step for success. But because payment under the current Resource Utilization Group (RUG) system is driven primarily by therapy minutes, capturing those conditions on the […]
Among the many skilled nursing landmines — from a new Medicare payment system to underfunded Medicaid programs to a shifting regulatory landscape — providers would be wise not to ignore the ongoing effects of bundled payment programs. In fact, at the end of a recent discussion on his research into the cost-savings successes and failures […]
Once the new Medicare payment model for nursing homes takes effect this fall, skilled nursing giant Genesis HealthCare (NYSE: GEN) expects to see significant expense savings — while also changing the way it negotiates therapy contracts with its third-party clients. The Kennett Square, Pa.-based operator projects that the expanded opportunity for group and concurrent therapy, […]
The administrator of the Centers for Medicare & Medicaid Services (CMS) placed nursing homes among her top areas of focus for the months to come, though she provided scant few other details during a wide-ranging press conference this week. “I’m spending a lot of time on nursing homes,” Seema Verma said in a Wednesday afternoon […]
Skilled nursing providers across the U.S. could be forgiven for feeling like they’re trapped in a word problem out of an algebra textbook when assessing the reimbursement for Medicaid patients — often the majority of residents inside a given facility. And despite some promising signs from the federal government, the coming changes to the Medicare […]
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