Providers taking part in a Medicare experiment saved money by funneling care away from skilled nursing facilities and toward physician services, according to a new analysis.
Instead of saving $2+ billion, early Medicare ACOs drove up federal healthcare costs $384 million, study findsMarch 30, 2018
An independent analysis from consulting firm Avalere finds the Medicare Shared Savings Program has underperformed when compared to the government's own cost-saving predictions.
We all yearn for a time when value-based purchasing (and care) loses its originality. A time when motivations for providing excellent care and achieving excellent resident outcomes are aligned with reimbursement.
Long-term care providers have an opportunity to thrive with value-based care, escape cynicism and join the growing wave successful at avoiding readmissions.
While hospital administrators or doctors may say that a note is a note, an assessment is an assessment, or a chart is a chart, they aren't acknowledging the uniqueness of the post-acute care environment—for example, how charts get audited is a completely different process, which means the information needs to be documented differently.
Hospice programs and SNFs must immediately implement a strategy to develop and market a strong, strategic nursing home/hospice partnership with hospitals, ACOs, MCOs, etc.
The finances of running a long-term care facility long have seemed like Monopoly. With each patient, you pass "Go," you collect $200.
We recently joined an ACO with the hopes of delivering a collaborative health care model that will bridge the gap between physicians, hospitals and skilled nursing providers to offer high-quality coordinated care to area seniors.
Partnerships linking skilled care operators and hospitals have been touted as all but inevitable. Yet good examples are few and far between. It turns out Dallas might be a pretty good place to look for a place to emulate.
You can forgive long-term care providers if they weren't outwardly jumping for joy at Monday's announcement that Medicare is going to start paying for quality, and not quantity, of services.
Don't count Rep. Diane Black among the supporters of the current model for accountable care organizations. The Tennessee Republican said late last week that it's too risky for providers who wish to participate.
If nothing else, federal health officials displayed Monday that they are intent on getting this accountable care organization (ACO) thing right. Or at least closer to "right" than it has been.
If there's anything that's become clear about this ACO business lately, it's that it's not going to be as simple as A-B-C.
A California healthcare system recently became the latest dropout from the Pioneer Accountable Care Organization program, citing the fact that payments are not adjusted by region. Sharp HealthCare announced the move in its third-quarter financial report.
Certain Accountable Care Organizations would be able to send Medicare beneficiaries to a skilled nursing facility without a prior hospital stay under a bipartisan bill recently introduced in the House of Representatives.
The Pioneer Accountable Care Organization program is now down to 19 programs, out of an original 32, worrying those who have pushed for skilled nursing facilities to embrace the concept.
A widespread lack of interoperable technology threatens the Accountable Care Organization model, according to recently released survey results.
The seeds that have flowered into the burgeoning of ACOs - groups of providers accepting the responsibility, and risk, for caring for the health of a designated patient population according to defined quality benchmarks (CMS measures quality of care using 33 measures in four key domains) - was planted long ago, in the baby boom.
SNF providers are scrambling to prepare to be "bought" by ACOs, aligned with potential bundling partners, selected as a preferred provider, and ultimately "sold" to the best, not highest, bidder.
Well-designed programs to coordinate care for patients with complex needs can reduce Medicare expenditures, including skilled nursing facility costs, according to an issue brief released Thursday by The Commonwealth Fund.
Accountable care organizations should be assessed on which patients bounce back to a member hospital within 30 days of being discharged to a skilled nursing facility, the Centers for Medicare & Medicaid Services asserts in a proposed rule.
The Medicare trust fund is on track to remain solvent until 2030, trustees of the program stated in a Congressional report released Monday. This improved outlook is due in part to revised expectations about the case mix in skilled nursing facilities.
In post-acute care, particularly the SNF future, it can be "Great" but there are so many "Perhaps" that the definition of what "Great" is going to be is unclear.
Skilled nursing facility readmissions should be an ACO quality measure, government proposes in payment ruleJuly 08, 2014
Accountable care organizations should be assessed on the number of people who return to a member hospital within 30 days of being discharged to a skilled nursing facility, the Centers for Medicare & Medicaid Services has stated in a proposed rule.
For skilled nursing facilities, the Medicare SNF 3-day rule can make it difficult to place the right patients in the right setting at the right time. The 3-day rule requires that a Medicare beneficiary spend three nights in a hospital as an inpatient — observation stays do not count — before becoming eligible for Medicare-covered SNF care. This rule creates a challenge for SNFs as hospital lengths of stay decline for many of the conditions that SNFs treat.
All ACOs should be allowed to waive 3-midnight requirement for Medicare skilled nursing coverage, MedPAC saysJune 18, 2014
Accountable care organizations should be able to place patients in skilled nursing facilities more quickly and communicate which SNFs are preferred providers, the Medicare Payment Advisory Commission stated in a letter to a top government health official.
Whether you're a long-term care leader who has already made the decision to align your organization with an ACO or are still in the process of weighing the decision, one thing everyone can agree on is this operating model will entail a significant amount of change in several key areas for participating long-term care providers.
Long-term care providers are participating in 'most ambitious test' of bundled payments, CMS announcesJanuary 31, 2014
Skilled nursing facilities and home health agencies are among 232 healthcare providers that have entered into agreements to take part in the Bundled Payments for Care Improvement initiative, the Centers for Medicare & Medicaid Services announced Thursday.
Skilled nursing and rehabilitation providers would be able to join networks dedicated to treating chronically ill Medicare patients, under a new bipartisan bill introduced Wednesday in both houses of Congress. The "Better Care, Lower Cost Act" seeks to establish the Better Care Program, which would enable healthcare providers to form networks similar to accountable care organizations, but with a special focus on coordinating care for those with chronic conditions.
In the early days of hospitalist medicine, we described the period between hospital discharge and follow-up at the skilled nursing facility, long-term care acute care hospital or a primary care physician as the infamous "Black Hole.