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Which Patient Populations Cause The Highest Readmissions?

In the third year of the Hospital Re­ad­mission Reduction Program (HRRP) (FY 2015), the proportion of hospitals receiving a penalty increased to 78 percent – up from 64 percent and 66 percent in 2013 and 2014 respectively. This increase is not surprising given that for 2015 penalties, CMS...

The Five Barriers to Accessing Palliative Care

By: Lisa Remington, President, Remington Health Strategy Group, and Publisher, The Remington Report Barriers to palliative care access in the United States occurs in five domains: Lack of AwarenessThe misperception among doctors and other health professionals that palliative care is appropriate...

Key Elements of a Successful Home-Based Palliative Care Program

By: Lisa Remington, President Remington Health Strategy Group, Publisher, The Remington Report The 2014 report “Dying in America,” by the Institute of Medicine, recommended that all people with serious advanced illness have access to palliative care. Many hospitals now have palliative care...

Standardizing Palliative Care Consultations

By: Lisa Remington, President, Remington Health Strategy Group, and Publisher, The Remington Report A study demonstrated that increased palliative care consultations for patients with advanced cancers is associated with substantial impact on 30-day readmission, administration of chemotherapy...

22 Key Facts About Physician CCM Billing

Frequently Asked Questions about Physician Billing for Chronic Care Management Services.  This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS) under CPT codes 99487, 99489 and 99490. January 18...

Home-Based Palliative Care Models

Palliative care focuses on relieving patients’ stress, pain and other symptoms as their health declines, and it helps them maintain their quality of life. It’s for people with serious illnesses, such as cancer, dementia and heart failure. The idea is for patients to get palliative care and then...

Identifying Key Transformation Trends in Bundled Payment Initiatives

Trend tracking can support your strategic planning and de-risk your future. Taking place right now are trends preparing the continuum of care for bundled payments. We take a look at significant changes to come...
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How Is Medicare Spending Per Beneficiary Linking Providers Across The Continuum

40% of the spending that comprises the Medicare Spending Per Beneficiary (MSPB) measure is accumulated outside of inpatient hospitalization. MSPB will be a quality measure across the healthcare continuum starting in 2017.
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New ACO Focuses On Managing High-Risk Patient Population

Some of the highest-need, highest risk Medicare beneficiaries are those enrolled in both Medicare and Medicaid.  In current Medicare ACO initiatives, beneficiaries who are Medicare-Medicaid enrollees may be attributed to ACOs. The Medicare ACO, however, does not have financial...

2018 Hospice Should Expect 1% Hike, CMS Proposes

Hospices would generally see a 1.0 percent ($180 million) increase in their Medicare payments for FY 2018, under Centers for Medicare & Medicaid Services (CMS) proposed regulations in the May 3 Federal Register. If finalized, the new payment rate will contrast with the one for fiscal 2017 - a...

How Do ACOs Address The Non-Medical Needs Of Patients?

ACO leaders identify and provide insights to how they are addressing the non-medical needs of patients. We explore key areas of transportation, housing and food insecurities. We take a look at CMS’ solutions and ways to solve barriers.
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Should Your Organization Look At Readmissions Prior To 30-Days?

Recent research suggests readmissions are higher within the first several days after discharge reaching its lowest point around seven days. Take a look at the analysis and check it against your own data.
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The Impact Of High Healthcare Spenders In Value-Based Care

As health system reform shifts payment away from fee-for-service to value-based care models, the incentives to focus on and improve care for high-cost patients will grow.
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The Five Barriers To EHR Use In Post-Acute Settings

Why are there not more post-acute providers using EHRs? Identified in this article is the GAO report about the five current EHR barriers and why the government’s overall plan is impacting usage.
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Are Medicare Advantage Plans The Next Big Play For Post-Acute?

Medicare Advantage now covers almost a third of all Medicare beneficiaries. In this article, we explore the importance of why Medicare Advantage Plans should coordinate with post-acute providers.
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What Does It Take To Be A Great Leader In Times Of Change?

In our insight series, we asked three successful healthcare organizations to tell us what they think it takes to achieve excellence amid the industry’s rapid changes. We share with you how these leaders are adapting, setting new direction, and embracing change. We interview: Joan Doyle, RN...

Primary Care Is Driving Care Coordination: Market Changes Ahead

Market conditions are sending strong signals about changing responsibilities and payments physicians will have for managing patients beyond the four walls of their offices. We explore three key game changing trends.
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2018 Hospice Proposed Rule For Payment Rates And Wage Index

On April 27, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1675-P) that would update fiscal year (FY) 2018 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries and releases Request for Information within the proposed...

Post-Acute Legislation to Watch

Key bills have been introduced in the new Congress, which are similar to those not acted on in the last Congress.   They are bipartisan measures, which should improve their chances of passage. Home Health Care Planning Improvement Act of 2017 * Legislation cosponsored by Sens. Susan...

Physician Practice Transformation: A Primer on MIPS and APMs

The Medi­care Access and CHIP Reauthori­zation Act (MACRA) went into law over a year ago. CMS released the first major regulation under MACRA, set­ting forth the new rules under this game-changing law. For now, only physician offices – not hospitals – are governed by MACRA rules. CMS...

End-of-Life Medicare Spending And The Cost Of Care Insights

Of the 2.6 million people who died in the U.S. in 2014, 2.1 million, or eight out of 10, were people on Medicare, making Medicare the largest insurer of medical care provided at the end of life. Spending on Medicare beneficiaries in their last year of life accounts for about 25% of total...

Readmission Insights Tied To Patient’s Socio-Demographic Status

Many post-acute care organizations are asking CMS to account for differences in patient populations. CMS is shaping a framework intended to allow better comparisons of post-acute care provided in four different settings. A roughly $60 billion annual expense for Medicare, the field involves the work...

Care Coordination High Priority For Bundled Payment Models

Care Coordination Significant To New Cardiac Bundled Payment Model The Centers for Medicare & Medicaid Services recently proposed a new payment model that would bundle payment to acute care hospitals for heart attack and cardiac bypass surgery services. In 2014, more than 200,000 Medicare...

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March/April 2019 Remington Report
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