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Resources to Drive Performance and Profitability:

Medicare Population Characteristics

In 2011, two-thirds of beneficiaries (66%) had three or more chronic conditions, more than one quarter of all beneficiaries (27%) reported being in fair or poor health, and just over 3 in 10 (31%) had a cognitive or mental impairment. (Figure1). Nearly one in six beneficiaries (17%) were under age...

Skilled Nursing Facilities Moving Into Value-Based Payments in 2019

Value-based purchasing programs for skilled nursing facilities (SNF) will begin in 2019. Beginning in 2018, skilled nursing facilities are required to take part in a quality reporting program. Those that do no do not submit data will be subject to a 2 percent reduction to their annual updates, CMS...

Do Medicare Hospital Star Ratings Correspond To Outcomes?

A study in The Journal of the American Medical Association (JAMA) investigates whether hospitals with more stars (on the Centers for Medicare and Medicaid Services rating system) have lower risk-adjusted 30-day mortality and readmissions than hospitals with less stars. The five-star rating system...

Hospice Quality Of Care Varies

In a large cohort study published in JAMA Internal Medicine, hospice visits in the last 2 days of life by professional staff varied by race, hospice program, and geographic region, with visits less likely if the patient was black, dying on a Sunday, or receiving care in a nursing home. These...

Palliative Care and Payor Value-Based Contracting

Payors are supporting palliative care through value-based contacts. Highmark is a regional payer organization that serves members throughout Pennsylvania, Delaware and West Virginia. It offers unique palliative care services to its Medicare Advantage members and supports hospital palliative care...

Skilled Nursing Facilities Test New Payments To Reduce Readmissions

CMS will test whether a new payment model for nursing facilities and practitioners will further reduce avoidable hospitalizations, lower combined Medicare and Medicaid spending, and improve the quality of care received by nursing facility residents. “Medicare currently pays physicians less for a...

Physician Leadership: Why Post-Acute Integration Matters

Brian D. Amdahl, MD, FCCP, MMM, is Executive Medical Director, VP for Post-Acute Services at HealthEast Care System, St. Paul, MN. This medical leadership role includes oversight for Bethesda Hospital, Home Care, LTACH, Hospice/Palliative Care, SNF/TCU, Community Care Management, and Medical Care...

EHRs Get Medicaid Funding

CMS announces an initiative to bring interoperable technology to a broader universe of health care providers, including long-term care, behavioral health providers, substance abuse treatment centers, and other providers that have been slower to adopt technology. The announcement will help to...

Long-Term Care Cost Market Scan

Over the next 40 years, the number of elderly US residents with a severe need for long-term services and supports (LTSS) will increase 140% to more than 15 million. Meanwhile US adults turning 65 today can expect to incur an average if $138,000 in LTSS costs. There is a wide risk distribution...

Aetna’s Compassionate Care Program for Advanced Illness

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 44 million people with information and resources to help them make better decisions about their health care. Their goal is to build a simpler, more integrated health care system that makes the...

Montefiore Health System’s Care Management Program

Located in the Bronx and Hudson Valley, New York, Montefiore Health System (MHS) serves one of the poorest and most disproportionately disease-burdened counties in the nation with nearly 80% of the payer mix from Medicare and Medicaid. The integrated delivery system includes 10 hospitals and...

Nine Building Blocks of Care Management

Successful care coordination programs employ a variety of tools to improve quality of care and reduce costs. To be effective, these programs must be flexible in design, implementation, and evaluation, rely on robust data sharing, incorporate patient engagement, and adapt to local needs. In...

Caregiver Market Trends

homA team led by Dr. Jennifer L. Wolff at the Johns Hopkins Bloomberg School of Public Health set out to examine the nature and intensity of involvement that caregivers provide, and to assess how it relates to their health and function. The researchers analyzed data from more than 1,700 family and...

Medicare Advantage Plans Adjusting Risk For Dual Eligibles

CMS has proposed changes to its risk adjustment model to address underpayments for certain low-income Medicare beneficiaries (“dual eligibles”), who tend to have higher healthcare costs than other enrollees. As a result of differences in how states cover dual eligibles, the changes could increase...

Quality Measures Development The IMPACT Act

Congressional approval of H.R. 4994, the IMPACT Act in October 2014, mandates the development and implementation of a standardized post-acute care assessment tool, and paves the way for effective payment reforms. The IMPACT Act: What’s Ahead  Preventable Readmission Measures CMS has...

Housecalls - A Physician's Perspective

Over the past twenty years I have made over 31,000 house calls to more than 4,000 home-limited patients (patients with difficulty leaving their homes). House calls markedly improve the quality of life of home-limited patients and their caregivers while dramatically reducing health care costs. With...

Palliative Care Readmission CHF Intervention Model

Healthcare systems are challenged by The Centers for Medicare and Medicaid (CMS) to reduce high cost hospital readmissions. Congestive Heart Failure (CHF) is one of the top 5 high cost readmissions. The traditional CHF hospital discharge management plan includes emergency room visits and hospital...

GAO Report: Community-Based Program Analysis

12 million of 16 million older adults who had difficulties with daily activities received limited or no home-based care. In 2011, the GAO analyzed 2008 data and found that approximately 9 percent of low-income older adults received meals like those provided by Title III programs (an estimated 1.6...

Emergency Dept. Study: Top 10 Reason Heart Failure Patients Go To The ED

A study in the Annals of Emergency Medicine, looked at why heart failure patients go to the Emergency Room. “In order to reduce the number of patients returning to the emergency department for heart failure exacerbations, we need a better handle on what they can and cannot do for themselves after...

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March/April 2019 Remington Report
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