Payment

CMS lowers pay hike for skilled nursing facilities to 1.2%

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Medicare skilled nursing facilities would get a net 1.2% pay increase — totaling $430 million — in fiscal 2016 under a final rule issued by the Centers for Medicare & Medicaid Services late Thursday.

Providers challenge proposal that adjusts payments, care

Providers challenge proposal that adjusts payments, care

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Providers in the post-acute care sector seem to be united in wanting BACPAC to take a hike.

Patient CARE Act is probed

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Because it does not allow for states' consent, the proposed Medicaid Patient CARE Act block-grant program likely will be considered unconstitutional, say two public policy authorities.

Ask the payment expert ... about quality metrics

Ask the payment expert ... about quality metrics

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A metric is a measurement of some sort of factor. For a quality metric, we are measuring quality in your facility. Companies measure performance against quality standards to determine whether they're meeting expectations. This measurement may be compared to benchmarks by labor market, by state or by national prevalence.

Dates, accurate data remain problems, MDS expert warns

Dates, accurate data remain problems, MDS expert warns

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Accuracy mistakes in MDS 3.0 data may cause additional payment problems, a reimbursement expert warns.

Fee-for-service still consumes most Medicare outlays: Report

Fee-for-service still consumes most Medicare outlays: Report

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Far more than half of the $360 billion in Medicare payments made just two years ago were based on traditional fee-for-service models without regard to quality or value, according to an independent report released Tuesday.

CMS plan would hike hospice rates in 2016

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The Centers for Medicare & Medicaid Services plans to raise hospice payment rates by nearly $200 million, or 2%, in fiscal year 2016. They come under a sweeping proposal establishing payment tiers based on length of stay and laying the groundwork for additional quality reporting measures.

What will it cost you to stay in the post-acute care game?

What will it cost you to stay in the post-acute care game?

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More than just collecting data, providers need to use standardized, nationally recognized measures. Especially in this era of ACOs and alternative payment models. In the past, many individual providers used their own methodology to create their own "data driven" story.

Nursing home operators hail 'historic' Senate passage of permanent 'doc fix' bill

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The Senate overwhelmingly voted to pass H.R. 2 Tuesday night, paving the way for repeal of the Medicare Sustainable Growth Rate and drawing the praise of the largest nursing home association in the country.

Online Expo begins Wednesday

It might still be snowing in some parts of the country, but there's no better sign of spring than the beginning of the McKnight's Online Expo.

ONE DAY TO GO: 9th Expo tackles rehospitalization rates, pay worries, pressure ulcers

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McKnight's 9th Annual Online Expo kicks off Wednesday, and organizers are bracing for record numbers of attendees.

Joint HHS, Justice efforts recoup $28 billion in Medicare payments

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The Justice Department announced on Thursday it had captured $3.3 billion from healthcare fraud prosecutions and other deals in 2014, bringing to nearly $28 billion the total amount it has recouped since the beginning of its 18-year-old Health Care Fraud and Abuse Control (HCFAC) Program.

Regaining an appreciation of prevention

Regaining an appreciation of prevention

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Healthcare is mandated to reduce spending. The problem is that the Centers for Medicare & Medicaid Services and others are so blinded by the "reduce spending" element that we have lost our ability to appreciate prevention.

Operators need to start asking a fundamental question: How they gonna pay?

Operators need to start asking a fundamental question: How they gonna pay?

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Conventional wisdom tells us that many existing options will not cut it as more discriminating customers arrive in long-term care. But maybe it's also time for operators to start giving more thought to a fundamental question: Will my future customers be able to pay?

Why providers aren't elated about new pay-for-quality goals

Why providers aren't elated about new pay-for-quality goals

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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.

Making the case: It's been a wild year

Making the case: It's been a wild year

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As the sands of the year race to their finish, there is one certainty about the long-term care news in 2014: It's been wild and trying.

New payment models clash with fraud laws; waivers might not be the answer, official says

New payment models clash with fraud laws; waivers might not be the answer, official says

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Healthcare payments linked to the quality of care are causing challenges to existing fraud and abuse laws, a government official said Wednesday.

SNF Open Door forum features blockbuster topics

The SNF Open Door Forum to be hosted Thursday by the Centers for Medicare & Medicaid Services should get the phone lines burning. PPS Payment reform, 2015 payroll staffing data collection, quality measures and more will be discussed.

Froyo funding for long-term care

Froyo funding for long-term care

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I have been blessed with an astute business mind, and am always on the lookout for new pricing models for long-term care. I know we're in this profession for love, not money. But no margin, no mission, as they say. Which is much better than what they used to say — no profit, no point.

Episode-based payment the focus of Sept. 23 McKnight's webinar

Episode-based payment the focus of Sept. 23 McKnight's webinar

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As value-based payment and delivery models take hold in Medicare, providers must shift their focus from managing stays to managing episodes of care. Experts from Avalere Health leading a McKnight's Sept. 23 free webinar will delve into how key episode-level data can help long-term care managers form strategies for participating in new models and networks.

It's not all bad news coming from MedPAC

It's not all bad news coming from MedPAC

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A funny thing happened on the way to a semi-annual eye-rolling over a MedPAC report. It gave me reason to sit up with interest. Even more unlikely, it contained information that made some long-term care providers happy.

Why nursing homes won't be catching many breaks this year

Why nursing homes won't be catching many breaks this year

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When you talk to experts in this field about the year ahead, an unsettling pattern soon emerges. Almost everyone seems fairly confident that regulators will be taking a much closer look at operators.

Not angry about the LTC Commission's report? You should be

Not angry about the LTC Commission's report? You should be

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It's hard to comment on the Commission on Long-Term Care's just-submitted report without getting hacked off. Really, really hacked off. To call it a fool's errand would be to insult misdirected dimwits.

Forecast error costs SNFs $320 million

Forecast error costs SNFs $320 million

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The nation's skilled nursing facilities can expect an aggregate $500 million boost in Medicare payments next year — $320 million less than the Centers for Medicare & Medicaid Services proposed.

Long-term care providers ready to deal with 'doc fix'

Long-term care providers ready to deal with 'doc fix'

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If you hang around long enough, you learn there are only two things long-term care providers fear after Republicans and Democrats. That would be hospitals and doctors.

Three White House appointees complete Commission on Long-Term Care

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President Barack Obama has named the final three members of the Commission on Long-Term Care created as part of January's fiscal cliff deal.

Hospitals are releasing too soon, but nursing homes can seize opportunities to reduce readmissions, INTERACT creator says

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Nursing homes need to build relationships with their local hospitals to reduce unnecessary readmissions, cut costs and provide better care, a geriatric expert said Thursday.

Too much provider consolidation leads to higher healthcare costs, expert says

Too much provider consolidation leads to higher healthcare costs, expert says

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Healthcare providers are increasing coordination to reduce the cost of care, but overly zealous consolidation can actually end up costing more, an expert panelist said at a Monday briefing.

House Republicans aim to block board's Medicare authority

House Republicans aim to block board's Medicare authority

Republican House leaders say they will continue to fight a part of the healthcare reform law that could lead to Medicare spending reductions without direct input from Congress. The House was scheduled to vote on rules for the 113th Congress Thursday. Part of them would include a GOP-promoted package that would disallow powers of the Independent Payment Advisory Board (IPAB).

New provider payment system needed, nursing home alliance says

New provider payment system needed, nursing home alliance says

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As federal debt negotiations continued Wednesday, an industry group unveiled its three-part plan for reform in post-acute care.

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