Accountable Care Organizations (ACOs)

BREAKING: Kathleen Sebelius to resign as HHS Secretary

In late-breaking news Thursday, Kathleen Sebelius is expected to resign as Secretary of Health and Human Services. Read More »

CMS boosts Medicare Advantage reimbursements for 2015

The Centers for Medicare & Medicaid Services issues several changes to 2015 pay rates amid pressure from the insurance industry. Read More »

Congress, LTC industry deliver bill to standardize post-acute care services

The draft legislation is here. But how much “IMPACT” would the Improving Medicare Post-Acute Care Transformation Act of 2014 have? Read More »

SGR ‘doc fix’ bill could delay ICD-10 by a year

A bill up for vote this week could extend the current "doc fix" and could delay the ICD-10 implementation deadlines for a year. Read More »

Acute and post-acute care unite

From courtship to a permanent union, hospitals and long-term care facilities have a lot to gain by working together. A look at the evolution of the AC/PAC relationship. Read More »

Obama’s FY15 budget proposal: What’s in it for long-term care?

President Obama’s budget for 2015 focuses heavily on healthcare, offering new funding for some and deeper cuts for others. Read More »

Post-acute orgs fear financial decline/buyouts due to technology gaps

Long-term and post-acute providers who fail to adopt information technology may find themselves at a distinct disadvantage—or owned by someone else—down the road, one survey report suggests. Read More »

Congress continues to wrangle with Medicare, Medicaid issues

Medicare physicians will automatically see a 24 percent reduction in pay if Congress does not act by March 31. Read More »

Bipartisan lawmakers strike deal to repeal SGR, set physician pay increases

A bipartisan team of lawmakers has struck a deal to repeal the sustainable growth rate (SGR) and set new guaranteed pay increase for physicians that provide services under Medicare. Read More »

HHS rule grants direct access to residents’ lab results

A new federal rule will allow senior care residents and their family designees direct access to lab test results, encouraging consumer care involvement. Read More »

CMS clarifies use of Medicaid funds in home, community-based settings

Stakeholder input helps CMS improve the accessibility of services for seniors and people with disabilities. Read More »

Federal agency recommends annual CT scans for older smokers

Privately insured smokers age 55 to 80 now have access to free annual lung cancer screenings—but the tests are not covered by Medicare. Read More »

Recovery audits: SNF psychiatric conditions

Does your skilled nursing facility care for residents with mental heath conditions? Medicare recovery audit contractors for mental illness issues may threaten access to care. Read More »

2014: The year of the ACO?

After a mixed year of progress and stumblings, accountable care organizations are expected to surge as a care model in 2014, according to a year-over-year trends report. Read More »

Killing the SGR and therapy caps

Congress may be ready to do away with the sustainable growth rate (SGR), re-fix the “doc fix” and ditch therapy caps, but will skilled nursing become the scapegoat for the costs? Read More »

OIG to CMS: Add hospitalization rates to nursing home quality ratings and surveys

The Office of Inspector General wants hospitalization rates to be added to CMS's nursing home quality rankings. But will the numbers tell the real story or just muddy the waters? Read More »

Bill introduced to protect seniors from healthcare scams

Healthcare scams have sprung up since the October rollout of the Affordable Care Act. A California congressman's response to healthcare scams victimizing seniors in his jurisdiction is introduced as a bill in Congress. Read More »

CMS issues 2014 Medicare payment rate updates

The Medicare payment updates for 2014 have been released. How can your facility best guide your own resident beneficiaries? Read More »

Eroding the payer/provider divide

Payers, providers and care networks are making vast efforts to combine care delivery, coverage and costs—merging control over the once-siloed segments of healthcare business. Will the post-acute care sector be the golden ticket to success or the cost-laden component that drags the system down? Read More »

Bundling without bungling

Bundling payments is becoming a reality for many long-term and post-acute care communities, but do you know where to start? Read More »

Omnicare settles $120M kickback suit

Long-term care pharmacy giant Omnicare has agreed to pay $120 million to end a lawsuit alleging kickbacks for skilled nursing medications. Read More »

Seniors with chronic diseases overpaying for medications

Seniors with diabetes, COPD, heart disease or Alzheimer’s disease need to pay careful attention when choosing a drug coverage plan, a new study says. Read More »

S.C. health system ordered to pay $276M in billing fines

A South Carolina health system owes the government millions for fraudulent billings and violations of the Stark anti-kickback law for the way it funnelled business to its outpatient services.  Read More »

House, Senate spar over a delay to ACA; shutdown looms

After a weekend of squabbling over the federal budget, the Senate has rejected a proposal to delay the Affordable Care Act. With the budget crisis still unsolved in the 11th hour, what would a government shutdown mean for long-term care? Read More »

Jacob Reider named acting national coordinator for ONC, David Muntz resigns

Farzad Mostashari, MD, has announced that Jacob Reider, MD, will take over as acting national coordinator. The ONC also announced that David Muntz has decided to step down as principal deputy national coordinator for health IT. Read More »

RACs are effective, but CMS should provide better oversight, says OIG report

Recovery Audit Contractors (RACs) are doing an effective job of rooting out Medicare fraud and billing errors, but federal Medicare agencies need to be more diligent about tracking cases, a new government report says. Read More »

Mostashari steps down from ONC

Farzad Mostashari, head of the Office of the National Coordinator for Health Information Technology (ONC) for the past four years, has announced his resignation. Read More »

House reps votes to delay employer, individual insurance mandates by one year

Following President Obama’s July 2 announcement to delay the employer insurance benefits mandate required by the ACA, the U.S. House voted today to delay the individual insurance mandate as well. But will the Senate agree? Read More »

9 ACOs plan to leave Pioneer Program

After one year, quality benchmarks may be up, but cost savings are not—and nine ACOs have decided to leave the Pioneer ACO program, CMS announced today. Read More »

Report lists 30 ways to address cognitive health

More than 280 public health experts put their heads together to come up with 30 ways to promote cognitive functioning and address impairment. A new report contains advice for those working with or caring for those with dementia. Read More »