I hung up the phone with the managed care case reviewer. The patient in question was in her late 50s, with multiple sclerosis and other physical problems that had left her bed-bound. What else would need to happen to get her more than a month of treatment? An amputation? The death of her only child?
Evidence-based quality data can be a powerful tool — especially for building partnerships with hospitals and managed care entities. These relationships will become increasingly important, making McKnight's free May 20 webcast a must-attend for forward-thinking providers.
Managed care is not being warmly embraced by long-term care providers everywhere. Nearly 40 states are in various completion phases of transitioning to privatized Medicaid managed care systems, but Louisiana's nursing homes are defiantly resisting efforts there to have them join the party.
While providers have made some progress with reducing rehospitalizations, the era of managed care organizations and better hospital partnerships means new strategies are needed. Attendees at the McKnight's Online Expo this month will learn nursing practices to reduce rehospitalizations and attract partners during the Quality session.
Hospitals traditionally have viewed a patient's discharge as the endpoint of their care responsibilities. In reality, hospital stays frequently are just one step in ongoing episodes of care. Ensuring a smooth transition from acute to post-acute and long-term care settings is critical to achieving optimal health outcomes, as well as preventing unnecessary hospital readmissions and emergency department visits.
Proposed regulations slated for early 2015 likely will affect how Medicaid managed care balances home- versus facility-based long-term care, news sources reported Wednesday.
More than three-quarters of Medicaid beneficiaries will be enrolled in a managed care plan as of 2016, according to an Avalere Health analysis released Thursday. The numbers reveal that managed care growth is especially strong in states that are expanding Medicaid.
The government should collect and release more claims information from managed care plans, the nation's largest long-term care provider association stated in a recent letter to Senate leaders.
McKnight's second Fall Online Expo takes place today, bringing long-term care professionals three free webcasts for continuing education credit. Experts will discuss regulatory compliance, strategies for working with difficult families and residents, and tips for managed care success.
McKnight's second Fall Online Expo will take place tomorrow, featuring three free webcasts on pressing long-term care issues. Attendees can earn continuing education credit while learning about regulatory compliance, strategies for handling difficult families and residents, and tips for finding success with managed care.
The government should collect and release more claims information from managed care plans, the nation's largest long-term care provider association stated in a recent letter to leaders of the Senate Finance Committee.
Providers should expect to be paid exclusively through managed care systems by 2025, a former White House adviser said in July.
Strokes declined 25% among seniors ... All nations should ensure long-term care for seniors, declaration to UN states ... Lawsuit: Shift to managed care denies home health services ... House bill would halt home health payment cuts
Managed care will completely replace today's healthcare payment system by 2025, former White House adviser saysJuly 02, 2014
Healthcare providers should expect that they will be paid exclusively through managed care systems by 2025, a former White House adviser said Tuesday.
The government's oversight of Medicaid managed care organizations is not strong, even though these entities cover about 50 million people and are growing rapidly, according to a recently released report from a watchdog agency.
Social involvement is No. 1 influence on nursing home residents' daytime sleep ... OIG casts doubt on managed care tax ... In potential Alzheimer's breakthrough, scientists use light to erase, restore rats' memories
Long-term care was the strongest healthcare sector for mergers and acquisitions last year, analysis showsMay 09, 2014
Long-term care was the only healthcare sector to experience an increase in mergers and acquisitions last year, according to a new analysis from business intelligence firm Irving Levin Associates Inc.
Skilled nursing facilities could take major hits to their bottom lines unless a coordinator is on top of managed care contracts, a prominent healthcare consultant said last month at the American College of Health Care Administrators annual meeting in Las Vegas.
Long-term care operators take note: You soon could fail residents, anger family members, increase survey deficiencies, drop Nursing Home Compare stars and lose money unless you hire a Coordinator of Coordinators.
Advanced certified nursing assistants — with specialized skills in care transitions, dementia and other areas — could become important staff leaders in long-term care facilities through newly proposed federal legislation. The "Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2014" was introduced Thursday by Rep. Matt Cartwright (D-PA) and Sen. Bob Casey (D-PA).
Skilled nursing facilities could lose big money if they don't hire a managed care coordinator, expert saysApril 08, 2014
Skilled nursing facilities stand to lose substantial sums of money as they increasingly do business with managed care plans, unless a coordinator is on top of exclusions and other contract elements, a prominent healthcare consultant told an audience Monday at the American College of Health Care Administrators annual meeting.
Federal investigators recovered more than $10 million in incorrect Medicaid payments made to nursing homes in 2013, an annual review shows.
Privately managed Medicaid threatens long-term care quality and options, New York Times article statesMarch 10, 2014
People with complex needs could find themselves squeezed out of the most appropriate long-term care settings as Medicaid beneficiaries become enrolled in programs from private sector companies, The New York Times reported in a lengthy Page 1 examination of the subject Friday.
As a child, Adrienne Mims, M.D., MPH, thought about being a lawyer. But when her beloved grandmother died of cervical cancer when she was in high school, she redirected her attention to a career in healthcare.
The federal government could reduce its Medicaid contributions to states as a deficit reduction measure, but the move likely would achieve savings only by putting seniors at risk, according to the Congressional Budget Office.
When the federal Commission on Long-term Care issued its report last month, there was a sense of déjà vu all over again. Sixteen years ago, in New York State, we were staff person and task force member, respectively, for New York's Task Force on Long-term care Financing. Despite the passage of time, there were some interesting similarities between the federal Commission and the New York State Task Force -- these included the compressed time frame for deliberations and the issuance of dissenting reports.
Captains of the long-term care profession get to their lofty positions by using their intellect and superior vision skills, as a gathering of minds recently re-emphasized.
Dual eligible managed care plans involved in an upcoming Centers for Medicare & Medicaid Services demonstration project will need to submit data in a variety of areas, the agency explained in a draft statement last week.
In a nutshell, troubled long-term care operators seem to be encountering this scenario with managed care companies: initial romance, followed by heightened accountability and reduced payments.
A facility that has proposed to offer grocery store gift cards in return for health screenings or clinical services will be sanctioned, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) has announced.