Kaiser Permanente’s virtual cardiac rehabilitation program has enrolled more than 2,300 patients, making it one of the largest such programs in the U.S.
For the first time since the early 20th century, the home has become the common place among American’s dying of natural causes.
Post-acute ACO adds 200 new long-term care facilities, new appointments, home medical equipment acquisitions, mergers and acquisitions, and more.
In 2019, Alzheimer’s and other dementias will cost the nation $290 billion. by 2050, these costs could rise as high as $1.1 trillion.
In 2019, access to MA plans remains high: 99 percent of Medicare beneficiaries have access to an MA plan, and 97 percent have an HMO or a local preferred provider organization (PPO) plan operating in their county of residence.
Medicare enrollment percentage in each state and the District of Columbia is listed below from largest to smallest.
Long-term care employers will need to fill 7.8 million total direct-care job openings from 2016 to 2026, according to a new analysis from PHI.
The 2018 annual average salaries for full-time nurses are ranked for all 50 states.
Market readiness is the theme for this year’s outlook. The talk of transformation has traction. Too many disruptors are in the healthcare market pushing out traditional models of care. Until you see the information gathered in one document, it may seem transformation is still a while away. Our study of trends and market signals indicate otherwise.
There is greater attention to “un-siloing” the care continuum. Lean into innovation. Market dynamics suggest the time is now.
Physician participation in accountable care organizations (ACOs) reached a milestone in 2018. More than half of physicians reported their practice was part of an ACO.
Changes to reimbursement for skilled nursing facilities and the physician fee schedule final rule have a major impact on the future of physical therapists and occupational therapists.
Market readiness is the theme for this year’s outlook. The talk of transformation has traction. Too many disruptors are in the healthcare market pushing out traditional models of care. Until you see the information gathered in one document, it may seem transformation is still a while away. Our study of trends and market signals indicate otherwise.
There’s been a significant industry-wide interest on “downshifting care” to lower-cost delivery environments. Harnessing the home as a central hub is getting the attention of physicians, payers and health systems as a way to transform traditional care management models with integrated home-based medicine.
An integrated program of services can contribute to reducing the cost of care and services to Medicare beneficiaries residing in seniors housing.
The tides are shifting the expectations of home care. Pressure from reimbursement, shifting payment models, and value-based care are driving the change.
Medicare improperly paid acute-care hospitals $54.4 million for 18,647 claims subject to the Post-Acute Care Transfer (PACT) policy.
Physical therapists once in such high-demand are facing massive layoffs across the industry because of reimbursement changes to skilled nursing facilities .
CMS is increasing payment for transitional care management services provided after discharge from an inpatient stay or certain outpatient stays.
You might want to pay attention to the water quality! A recent study ranks the water served on major and regional US airlines.
Starting November 1, UnitedHealthcare will not pay for unplanned surgeries in an outpatient setting unless it determines the site is medically necessary.
FREE ARTICLE: What post-acute care providers need to know about a new rule that includes updated payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule.
The new rules will give providers in value-based arrangements greater certainty and ease the compliance burden for providers across the industry.
Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home care.
Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home care.
Private Medicare plans will soon include expanded plan options for seniors, more telehealth, and innovative plan designs and payment models.
Including unpaid caregivers into discharge planning for the elderly patient population reduces readmissions.
New Discharge Planning Conditions of Participation require hospitals to assist patients, their families/caregivers in selecting a post-acute care provider.
Medicare Advantage (MA) Plans are adding two new dementia codes in their risk adjustment payment system and expanding flexibility in the MA benefit design.
A unified value-based incentive program for SNFs, home health services, inpatient rehabilitation facilities, and long-term care hospitals is recommended.
A GAO report explored the efforts to manage high-expenditure beneficiaries, which are 5% of all Medicaid beneficiaries but nearly half of all expenditures.
A GAO report explored the efforts to manage high-expenditure beneficiaries, which are 5% of all Medicaid beneficiaries but nearly half of all expenditures.
A unified value-based incentive program for SNFs, home health services, inpatient rehabilitation facilities, and long-term care hospitals is recommended.
FREE ARTICLE: Seven guided questions for strategic planning. Six external trends for home care companies to keep an eye on. 10 challenges ahead for home care companies.
Through initiatives that change how heathcare is delivered and physicians are paid, CMS is driving toward the goals of improving quality and reducing costs.
MACRA is a law that builds a new, fast-speed highway to take the healthcare system away from fee-for-service and toward coordinated care models.
CMS published a rule on Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APM) incentives under MACRA.
CMS released the first major regulation under MACRA. For now, only physician offices – not hospitals – are governed by MACRA rules.
Physician and post-acute providers can partner together to provide chronic care management through annual wellness programs visits.
The top six types of providers who provided home-based medical care (non-podiatry) in both 2012 and 2013 accounted for two-thirds of the providers.
Payers and providers are redefining and rethinking how new models of care can move the needle toward value-based care.
Community paramedicine is a new model of healthcare in which paramedics function outside their customary emergency response and transport roles.
A study in the Annals of Emergency Medicine, looked at why heart failure patients go to the Emergency Room.
Including unpaid caregivers into discharge planning for the elderly patient population reduces readmissions.
Study estimates a total annual value opportunity of $31 billion in the Medicare market through integration of mental health medical treatments.
This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule.
The Stark Law is a set of U.S. federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient.
Congressional approval of the IMPACT Act in October 2014, mandates the development and implementation of a standardized post-acute care assessment tool.
Section 2(a) of the 2014 IMPACT Act requires post-acute providers to submit standardized patient assessment data, as well as standardized quality measures.
Four healthcare settings must report standardized data using the assessment instruments on at least five of the following eight quality measure domains.
Under the proposed rule, hospitals and critical access hospitals would be required to develop a discharge plan within 24 hours of admission or registration.
n keeping with the requirements of the IMPACT Act, measures for the other domains will be addressed through future rulemaking.
CMS has contracted with Abt Associates and RTI International to develop a cross-setting Post-Acute Care measure for medication reconciliation.
The PPS prototype that has been developed accurately predicts resource needs for nearly all patient groups, indicating it can be used to set fair payments.
CMS issued new guidance to clarify where Medicaid beneficiaries can receive home- and community-based services as defined in a 2014 regulation.
Kaiser Permanente Colorado and VNA-Denver jointly offer intense, consistent education to elderly heart failure patients discharged from the hospital.
Sharp HealthCare pre-hospice program called Transitions, is designed to give elderly patients the care they want at home and keep them out of the hospital.
Fragmentation of the care delivery system is widely recognized as a cause of missed opportunities to treat both acute and chronic conditions.
The program at Washington Hospital Center has lowered total costs of care and has reduced average inpatient length of stay from 8 to 6 days.
In the proposed rules announced by CMS, SNFs will get an $800 million, or 2.1%, Medicare payment increase under the proposed rule for FY 2017.
Key takeaways from the perspective of primary care office help stakeholders to better understand care management population health models.
People who are continuously enrolled in Medicare Advantage are less likely to die in a hospital than those continuously enrolled in Medicare fee-for-service.
All Medicare-certified home health agencies in nine states will compete on value in the HHVBP model, where payment is tied to quality performance.
A recent filing by Humana indicates the insurer is instituting a new bonus plan that is not just tied to financial performance, but also to health outcomes.
CPC+ is a national advanced primary care medical home model that aims to strengthen primary care through a regionally-based multi-payer payment reform.
Successful care coordination programs employ a variety of tools to improve quality of care and reduce costs, including flexibility in design.
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.
In 2011, two-thirds of beneficiaries had three or more chronic conditions, more than one quarter of all beneficiaries reported being in fair or poor health.
CMS recently proposed a new payment model that would bundle payment to acute care hospitals for heart attack and cardiac bypass surgery services.
The OIG held a roundtable to discuss a broad range of ideas regarding how healthcare organizations can measure their compliance program effectiveness.
Cancer accounts for less than one-half of all hospice admissions. Here is a list of the top 13 diagnoses for admissions to hospice care.
Barriers to palliative care access in the United States occurs in five domains. Learn what these domains are in this article.
Payers and Alternative Payment Models (APMs) are turning to palliative care programs as a way to offer value-based end-of-life care.
Increasing hospice services can reduce hospital admissions among all residents of a nursing home, including those not enrolled in hospice.
One of five people with self-care disabilities reported negative consequences from not having help with activities they had trouble performing on their own.
Fall-related injuries are a major reason why seniors are readmitted to the hospital within a month after being discharged, a new study finds.
A panel of eldercare experts released its definition for person-centered care, which stresses collaboration between the patient, family, and provider.
A recent study in the New England Journal of Medicine by Partners HealthCare System examines community-based linkages to population health.
Medicaid’s reform will lead to greater care coordination, a focus on reducing costs and more possibilities of risk and preferred provider networks.
A report from MedPAC staff outlined the pros and cons of an episode-based payment approach compared to a stay-based payment approach.
Congressional approval of the IMPACT Act in October 2014, mandates the development and implementation of a standardized post-acute care assessment, too.
Exploring similarities in PAC settings flushes out what is presently aligned for the model to work, and identifies where there are gaps.
Key strategies to accomplish clinical continuum includes reducing the cost of care and developing post-acute tools for redefining partnerships.
Novant participated in a VHA research project that significantly reduced overall readmissions and those related to adverse drug events.
From July to December 2014, VNA Healthtrends, a leading home health provider, enrolled 51 patients in their Hospital to Home Program.
Patients sent home after knee and hip replacements do not have higher rates of medical complications, returns to the hospital or E.R. visits
Palliative care focuses on relieving patients’ stress, pain and other symptoms as their health declines, and it helps them maintain their quality of life.
Aetna’s Compassionate Care Program is designed to improve the quality of patient care for individuals with life-threatening illnesses.
In a large cohort study, hospice visits in the last 2 days of life by professional staff varied by race, hospice program, and geographic region.
Despite recommendations to the contrary, only about half of elderly patients with advanced cancer receive palliative care.
A new guidance statement to define high-quality primary palliative care delivery in medical oncology has been developed by ASCO and AAHPM.
Spending on Medicare beneficiaries in their last year of life accounts for about 25% of total Medicare spending on beneficiaries age 65 or older.
Four key trends in hospice care are contributing to a paradigm shift and impacting the future of Medicare hospice providers and other providers.
Highmark offers unique palliative care services to its Medicare Advantage members and supports hospital palliative care through value-based contracts.
The ACO Investment Model encourages new ACOs to form in rural areas and Medicare Shared Savings Program ACOs to take greater financial risk.
17 states are implementing accountable care strategies in Medicaid or state employee health programs and patterns have begun to emerge.
The ACO model has the right incentives to reduce variation, spur innovation, and improve quality in end-of-life (EOL) care
Early evidence suggests that, under episode-based incentives, clinicians and organizations can improve the value of care for certain episodes.
A home-based palliative care program tested within an ACO showed cost savings and reduced hospital admissions for patients near the end of life.
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