Five of the leading U.S. healthcare organizations got a prickly letter from the Department of Justice and Health & Human Services Monday: Stop misusing documentation and electronic medical record technology systems for fraudulent billing purposes, or else. Read More »
The United States isn’t the only country experiencing explosive growth within the senior demographic. As the elderly population and the costs of senior care rise across the globe, other countries are weighing the U.S. long-term care experience. How will they handle the need for expanded senior services? Read More »
The United States isn’t the only country experiencing explosive growth within the senior demographic. As the elderly population and the costs of senior care rise across the globe, other countries are weighing the U.S. long-term care experience. Read More »
A bipartisan Congressional group introduces the Medicare Transitional Care Act of 2012, moving ahead to formalize reimbursement for care transitions. Read More »
Medicare providers could be facing a $11 billion reduction in reimbursements if the government's sequestration process goes forward, according to an OMB report released today. Read More »
Five years of data from Center for Medicare & Medicaid’s largest experiment in performance-based reimbursement are mixed, but physician groups succeeded in slashing the costs for dual-eligibles. Read More »
What started out as a comparative analysis on reimbursement rates related to catheter-based urinary tract infections (CAUTIs) has opened a huge can of worms concerning hospital datasets and their reliability as performance measurements. Read More »
The healthcare system has taken three large steps toward longitudinal care—and toward embracing long-term/post-acute care’s role in that picture. Progress on the Meaningful Use stages and templates for the new Continuity of Care Document were among the highlights. Read More »
In a milestone report released today, the Institute of Medicine (IOM) analyzes why the U.S. healthcare system needs a new business-based attitude, and why it struggles to learn from its own data. Read More »
The Centers for Medicare & Medicaid Services' rule on hospital "observation stays" has generated much controversy. The American Health Care Association strikes back with a long list of changes that should be made--and why. Read More »
In March 2013, the majority of nursing home residents will experience a radical change—no more government checks in the mail. Long-term care facilities should start now to educate their staffers and their residents on the new electronic direct deposit system. Read More »
When it comes to getting Medicaid assistance for long-term care costs, too many rule variations among the states have created a chaotic system, a GAO report concludes. Read More »
The Centers for Medicare & Medicare Services on Friday published a final rule pushing back the compliance deadline for converting to the ICD-10 system of diagnostic and procedural coding to October 1, 2014 from October 1, 2013. Read More »
Ohio is the latest state to launch a pay-for-quality program for skilled nursing reimbursement. But with 10 percent of reimbursement riding on passing the quality program, is the test tough enough? Read More »
As Medicare and Medicaid programs grow, the insurance market is spending billions to get a larger slice of the government-backed healthcare markets. Read More »
Don’t know what data analytics is yet? More hospitals are realizing the potential of data analytics to improve quality and business operations, and the transitions of care initiatives might bring LTC into the analytics mix sooner than you think. Read More »
As reimbursement becomes increasingly tied to clinical quality and performance, Ohio joins the list of states that are trying a bigger carrot instead of the stick. Read More »
The billing differences between inpatient and observation hospitalizations are causing plenty of headaches, but the American Health Care Association believes CMS’ new pilot program is a step in the right direction. Read More »
A growing number of seniors who have observational hospital stays are getting stuck with the bill for their SNF care. CMS is launching a new pilot to try to iron out the wrinkles in the claims system. Read More »
A recent study indicates that today’s seniors have better vision than the elderly of a generation ago. Better vision promotes more independence in performing daily activities. Read More »
Home healthcare agencies are the focus of $5 million in suspect Medicare claims, according to this week's report from the Office of Inspector General. Read More »
In this week's blog, John Derr, RPh, discusses the importance of harmony between clinical design and information technology. Successful implementation of transitions of care and longitudinal health records will require bringing both the clinical side and the technology side into the future together. Read More »
The unfortunate overlap of multiple payment-reduction laws and regulations could add up to $65 billion less for skilled nursing home budgets over the next 10 years, according to nationwide data released today. Read More »
The Centers for Medicare & Medicaid Services is finally set to begin a three-year project to reduce fraud and errors by using RACs to check Medicare claims before they move to the payment stage. Read More »
As states debate whether to adopt Medicaid expansion or not, the latest public health study from Harvard suggests expansion might be a healthy idea. Read More »
HHS has announced a public-private collaboration aimed at stemming healthcare fraud. Tougher sentences, suspended payments and enhanced screenings are tools now available for enforcement through the Affordable Care Act. Read More »
The Department of Health & Human Services has released the LTC chapter in the national plan to reduce infections: C. difficile and urinary tract infections are the first of many high-priority targets. Read More »
