Reimbursement

LTC transitions of care: Get collaborative or play catch-up, says national TOC group

Are transitions of care on your mind? You’re not alone. Read our on-site coverage of the National Transitions of Care Coalition (NTOCC) Midwest Regional Summit, held this month in Cleveland, for tips and free tools to improve your TOC efforts. Read More »

Henry Ford and Beaumont health systems to merge hospitals, LTC care sites

Updated: 5/21/13: Both parties have decided to cancel merger talks for now. The continuum of care gets bigger and broader in Michigan as two health systems join to form one of the largest non-profits in the state. Read More »

Need technology? Take the trauma out of your IT initiatives

Technology projects planned with the input of all departments have the best staff buy-in and training engagement, says a panel of long-term care project managers who have tackled the IT challenges in their own organizations. Avoid “tech trauma” by learning their tips on IT project strategy. Read More »

LeadingAge to LTC providers: Demand change in healthcare delivery system

The overriding message from LeadingAge thought leaders at the group's annual meeting is that providers must step up to the plate and demand a say in the future of the country’s bloated and broken healthcare delivery system. Read More »

LTC industry uses election campaign to combat federal program cuts

With the national elections drawing ever closer, the long-term care industry continues to turn up the heat on lawmakers, urging them to avoid additional cuts in federal funds for programs that support services to the elderly. Read More »

Senior housing providers branch into at-home care models

With more Americans considering staying at home in their elder years instead of moving to a retirement community, many senior living providers are experimenting with alternative service models, including innovative programming and service partnerships. Read More »

LTC trends report: Reimbursement #1 challenge, technology #1 game changer

Amid the cuts in payments and struggles with occupancy rates, the current long-term care business environment has opportunities for innovation in cost models, care delivery models and technology-driven value, notes the 28th annual Licensed Nursing Facility Cost Comparison. Read More »

How well can we control healthcare-associated infections (HAIs)?

Several recent studies show varying levels of success for infection-reduction programs, including efforts to curb MRSA, CLABSI and CAUTI rates. But the jury is still out on whether healthcare-associated infection (HAI) programs are making progress because of Medicare's new policies—or in spite of them. Read More »

Most Medicare seniors overspend by choosing the wrong Part D drug plan

Most Medicare beneficiaries are spending more than they need to on Medicare drug plans and should find Plan B within Part D, according to a University of Pittsburgh School of Public Health study. Read More »

“Frequent users” are not abusing ER services, multi-state studies say

Seniors have been accused of overusing the Emergency Room, often as a substitute primary care provider. But new studies from a national emergency medicine association say that their ER visits are usually justified. Read More »

One-year look-back: Assessing 2012’s Final Rule and its impact on providers

The Centers for Medicare & Medicaid Services’ (CMS’) skilled nursing facility 2012 Final Rule has had a huge impact on SNFs that were still adjusting to the transition to MDS 3.0 the previous year. Read More »

AHCA/NCAL: Future of LTC relies on leadership and resilience

A few raindrops didn't dampen the spirits of more than 2,000 attendees and 350+ vendors who celebrated the resilience and discussed the challenges of long-term care on today's opening day of the AHCA/NCAL Conference and Expo in Tampa, Fla. Read More »

DOJ & HHS charge 91 people with $430 million in Medicare fraud

A federal strike force from the Department of health & Human Services and the U.S. Atorney General’s office have charged almost 100 people with a total of $430 million in fraudulent Medicare billing practices. Read More »

Turning a blind eye to the rules

Sharon A. Nazarchuk and Timothy Legg studied a pool of skilled nursing facilities to uncover discrepancies in survey data, including why skilled nursing facilities can fail to employ qualified activity directors yet still escape citations during the survey process. Read More »

Is your LTC facility primed for HIT implementation and training?

October brings many key healthcare conferences and a renewed focus on the stages of implementing healthcare information technology in the long-term care setting. Is your facility ready to implement HIT systems for longitudinal care quality and transitions of care? Read More »

Hospital readmission penalties off to a rocky start

CMS’ new program to make hospitals financially accountable for excessive readmissions stumbles at the starting gate, as CMS issues a document to correct errors in the final rule. Read More »

Report compares healthcare plans under Obama, Romney

As the presidential debates begin this week, Medicare is predicted to be a hot-button topic. One private foundation released a report that explores the differences and similarities between the healthcare plans of both presidential candidates. Read More »

New surgical guide for elderly optimizes care coordination

A new guide, co-developed by the American Geriatrics Society and the American College of Surgeons, outlines the key assessment needs and risks of elderly surgery patients, including dementia, mobility and medication management. Read More »

CMS launches SNF program to reduce hospital readmissions

As concerns over hospital readmissions grow, the Centers for Medicare & Medicaid Services has launched a program to encourage SNFs and state agencies to collaborate on avoidable conditions and the costs they incur. Read More »

DOJ & HHS: Stop abusing electronic record technology for fraudulent Medicare billing

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 »

Congress introduces Medicare transitions of care legislation

A bipartisan Congressional group introduces the Medicare Transitional Care Act of 2012, moving ahead to formalize reimbursement for care transitions. Read More »

OMB: Medicare providers could see $11 billion in reduced payments in 2013

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 »

Largest ACO model project sees significant savings among dual-eligibles

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 »

UTI payment study reveals big holes in datasets used for performance measures

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 »

California passes bill restricting emergency room charges for out-of-network patients

California legislature has passed a bill limiting what emergency departments can charge out-of-network payers. Will other states follow? Read More »

Care during last five years of life could cost $38-66k or more, study says

The last five years of life can cost a bundle, even with Medicare coverage, reveals a new study published in the Journal of General Internal Medicine. Read More »

Longitudinal care and the LTPAC world

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 »

IOM report: Healthcare must behave more like a business, reward quality and learn from data

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 »

AHCA adds predictive data analytics to national quality initiative

The American Health Care Association has added a new technology tool for long-term care facilities to analyze their quality performance and to help reduce hospital readmissions. Read More »

Too little standardization in how states verify Medicaid applicants, GAO report says

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 »