Accountable Care Organizations (ACOs)

CMS: Waiver status issued for New York state in Sandy’s wake

An emergency response meeting held by the Centers for Medicare & Medicaid Services answers some questions on coping with the aftermath of Hurricane Sandy in New York, but many issues remain for long-term and acute care facilities in other states. Read More »

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 »

National collaborative will foster innovation in senior housing and financing models

A national learning collaborative, launched at this week’s LeadingAge conference, is focused on creating new financial and service strategies for senior living. 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 »

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 »

Preparing for the ‘silver tsunami’ across the globe

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 »

Preparing for the ‘silver tsunami’ across the globe

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 »

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 »

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 »

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 »

Aetna buys Coventry Health Care in latest deal to divvy up Medicare/Medicaid expansion market

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 »

Penalties for readmissions could hit low-income regions below the belt

CMS penalties for readmissions will have disproportionate effects on healthcare facilities in lower-income communities. Read More »

HHS: Long-term care is the next step in national plan to combat infections

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 »

MU Stage 2: Rule at final step before publication

The Stage 2 Meaningful Use rule has been submitted to the Office of Management and Budget--the last stop in the review process. Read More »

Healthcare and drug costs still surprise retirees

What tops your retirement wish list? Most retirees would gladly trade the dream of a beach house in Florida for lower healthcare and prescription drug costs, as well as more education on financial planning, an insurer survey shows. Read More »

CMS announces 89 new ACOs

As of July 1, 89 new accountable care organizations (ACOs) began serving 1.2 million people with Medicare in 40 states and Washington, D.C., the Centers for Medicare & Medicaid Services announced today. Read More »

CMS proposes higher pay rates for end-stage renal disease

The Centers for Medicare & Medicaid Services has proposed policy changes that would increase reimbursement rates for end-stage renal disease services. Performance data collected next year would affect the payment rates starting in 2015. Read More »

LTC leaders analyze impacts of ACA decision

Leaders digest: So the ACA stays. What now? Long-Term Living’s editors speak with leaders in the long-term and post-acute care industry the day the Supreme Court decision is announced. Read More »

Supreme Court upholds Affordable Care Act

BREAKING NEWS: Supreme Court has decided the Affordable Care Act will stay in place. The majority voted to keep individual mandate and the right for Congress to offer funding for state reform programs. Read More »

Payors line up to carry the reform mantle if ACA falls

Some insurers aren't waiting for the Supreme Court's decision to show how they feel about some of the reforms within the Affordable Care Act. Read More »

Hospital readmissions won’t improve without better transitions of care

Solving the problem of hospital readmissions will take much more than follow-up calls at home. Each link in the care chain has quality improvements to make, say health IT experts at the 2012 LTPAC Health IT Summit. Read More »

eHDS User Group: While CMS continues to innovate, unpredictable Congress could cut healthcare funding

NASL’s Cynthia Morton shares insights on Congressional legislation and CMS innovation projects with attendees at this week’s eHDS User Group meeting. Read More »

Competitive bidding saves Medicare $202 million

A report issued by HHS Secretary Kathleen Sebelius credits the Medicare competitive bidding program for saving $202 million for people on Medicare who require durable medical equipment. Read More »

CMS announces 27 Shared Savings ACOs

More than 1.1 million beneficiaries are receiving care from providers participating in Medicare shared savings initiatives. CMS says it is reviewing more than 150 applications from ACOs seeking to enter the program in July. Read More »

Poll: Most healthcare organizations not optimistic on ACO participation

The executives surveyed said their organizations do not have a comprehensive understanding of the various CMS programs and their financial implications, even after publication of final rules. Read More »

10 top LTC news stories of 2011

This year, providers faced waves of regulatory, economic and societal challenges that tested their adaptability and fortitude. Read More »