Accountable Care Organizations (ACOs)

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 »

CMS proposal: Ditch “coding levels” for outpatient services

A new payment proposal from the Centers for Medicare & Medicaid Services (CMS) could impact the reimbursements for long-term care hospitals, post-acute care and rehab facilities. Read More »

CMS limits Medicare coverage of exorbitant brain test to specific cases

There’s a brand-new imaging test available to diagnose Alzheimer’s disease, but it’s so expensive that CMS is limiting the Medicare coverage of the test to two circumstances. Read More »

CMS revises discharge planning guidelines

New CMS guidelines take a deeper look at discharge planning, clarifying who is responsible for what at the time of discharge and why discharge planning is a key to reducing 30-day readmissions. Read More »

CMMI rethinks its innovation program, sharpens focus for Round 2 funding

CMS’ Center for Medicare and Medicaid Innovation (CMMI) announces a significantly smaller and more-focused project list for Round Two of the funding awards. Read More »

CMS proposes $180 million increase in hospice reimbursements

CMS has proposed a new rule that would raise hospice payments under Medicare by $180 million next year. Read More »

CMS sweetens the deal for fraud whistleblowers

Know about someone conducting sneaky Medicare billing practices? CMS’ new whistleblower proposal might pay you more than your boss does. Read More »

Senate committee approves Tavenner for CMS helm

Marilyn Tavenner has obtained a vote of confidence from a Senate committee in her bid to become the first confirmed administrator of the Centers for Medicare & Medicaid Services in seven years. Read More »

Industry leaders weigh in on President Obama’s FY2014 budget proposal

This summer will be a busy one as Congress deliberates the 2014 budget and how, without revisions, its proposed cuts to Medicare may affect the physicians, hospitals and long-term care providers. Read More »

The pros and cons of per capita caps for Medicaid

Federal agencies and lawmakers keep revising one possible way to curb Medicaid spending growth: Per capita caps. Read More »

Obama budget will cut Medicare but boost Medicaid and mental health

President Obama's new budget, released by the White House Wednesday, includes plenty of cuts, but also contains a few surprising increases. Read More »

CMS releases guidelines on delegated nursing roles in SNFs

A new Centers for Medicare & Medicaid Services document clarifies what tasks physicians may delegate to nurses within nursing homes serving Medicare and Medicaid residents. Read More »

One-on-one with…. Ruta Kadonoff

Senior Editor Pamela Tabar talks with Ruta Kadonoff, vice president of quality and regulatory affairs for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), about quality in long-term care—and why being able to measure it will be important for business. Read More »

2% Medicare payment reductions begin today

The waiting is over. No resolution to the budget crisis means that sequestration begins—today. Long-term care facilities will feel the effects upfront, but a quieter casuality might be healthcare's information technology and data-sharing initiatives. Read More »

White House, Congress might consider combining Medicare Parts A and B

Sweeping changes may be on the horizon for the way Medicare billing is divided, as President Obama and Republicans put the idea of combining Medicare Parts A and B back on the discussion table, the New York Times reports today. Read More »

CMMI, Senate committee lock horns over innovation projects

The Center for Medicare and Medicaid Innovation (CMMI) got a tongue-lashing from the Senate Finance Committee, while CMMI’s director explains that testing new models takes time before payment reforms can be put into action. Read More »

MedPAC to Congress: Reduce SNF payments by 4% in 2014

Skilled nursing facilities and home health agencies face payment reductions, but hospices and long-term care hospitals get a first-round bye in MedPAC's latest Medicare payment recommendations to Congress. Read More »

Final 3 members appointed to LTC commission

President Obama adds the last three names to the Long Term Care Commission, completing the group's bipartisan membership. Read More »

Social services key to delivering senior healthcare at lower cost

Improving healthcare delivery for seniors might take greater investment in an often-ignored component: Social services. Read More »

SNF surveys: Do they tell the whole story?

Nursing home consumers—residents and their families—say the survey process has flaws that need to be addressed, according to a new report from the Coalition for Quality Care. Read More »

CMS: Penalties are working to reduce hospital readmissions

New data on hospital readmission shows that healthcare reform is making an impact--changing the rates for the first time in five years, says CMS. Read More »

Calif. plans 85% increase in LTC insurance rates for public employees

The California Public Employees’ Retirement System, the country's third-largest health benefits purchaser,  dropped a bombshell on its long-term care policyholders—switch LTC policies or deal with a massive rate increase. Read More »

OIG: Nursing homes provide ‘criminally poor care,’ fail on care plans

A new report from the Office of Inspector General accuses skilled nursing facilities (SNFs) of misusing their Medicare payments, since more than one-third of SNFs don’t fulfill—or even create—the care plans and discharge goals required for their residents. Read More »

N.J.’s Gov. Christie joins GOPs reconsidering Medicaid expansion

N.J.’s Gov. Chris Christie is the latest republican governor to change his mind about expanding the state Medicaid program. Read More »

C. Everett Koop dies at 96

Widely recognized by his bushy beard and somber uniform, former U.S. Surgeon General C. Everett Koop became a household name for his anti-smoking campaign. Read More »

The SCOOTER Store is back on the hot seat

A popular provider of power chairs gets a visit from federal agents in a new Medicare fraud investigation. Read More »

Therapy caps: Unraveling the spider’s web for long-term care

How many of your residents are on track to exceed the $1,900 payment cap on physical or occupational therapies? We examine the current therapy cap situation, and why it's such a challenge for long-term and post-acute care. Read More »

Fla. governor reverses stance, now supports Medicaid expansion

Florida’s governor, once one of the loudest voices against “ObamaCare,” has done a policy about-face and now supports limited Medicaid expansion in the state. Read More »

CMS proposes lower Part D deductibles, slashed insurer payments for Medicare Advantage plans

The Centers for Medicare & Medicaid Services has released its proposals for rate and payment changes for 2014. Seniors may be happy about the Part D drug changes, but insurers aren't as pleased with their end of deal. Read More »