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The Real Cost of Hospital Readmission Rates

Starting this year, the Centers for Medicare and Medicaid Services (CMS) fees are being strongly enforced and will affect many non-complying hospitals. The cost of hospital readmission is already extensive for health care payors and patients, and now hospitals will be financially impacted as well. CMS’s hospital penalties are expected to reach $428 million inRead the Rest…


Will Changes to Five-Star Rating System Bring Improvement?

As of 2014, there were 15,800 nursing home facilities caring for approximately 1.4 million residents in the United States, according to the Centers for Medicare and Medicaid Services (CMS). Of the entire U.S. population, 0.9% age 65-74, 3.2% age 75-84 and 11.2% over the age of 85 reside in nursing facilities, according to the U.S.Read the Rest…


States Contributing to Medicaid and Medicare Savings

Many elderly and disabled low-income Americans qualify for both Medicare and Medicaid coverage. They are referred to as dual eligible. Medicare, which was created to provide medical coverage for seniors and people with disabilities has 37 million enrollees. Medicaid, which was created to provide medical coverage for the poor has 51 million. There are currentlyRead the Rest…


Doc Fix Could Depend on Post-Acute Care

In 1997, as part of the Balanced Budget Act, the Medicare Sustainable Growth Rate (SGR) was enacted in an attempt to manage Medicare’s spending on physician services. Every year since the SGRs inception, Congress has attempted to avoid implementing its proposed physician reimbursement cuts. This past March, another “patch” was plastered on the SGR –Read the Rest…


Better Care Lower Cost Act Provides Care for Chronically Ill Seniors

The fastest growing portion of Medicare enrollees is also the most expensive group to provide services to. The Better Care Lower Cost Act is intended to create substantial Medicare savings while improving care for these patients who typically have multiple chronic conditions. The numbers are astounding: Medicare beneficiaries with two or more chronic conditions accountRead the Rest…


Medicare Data Delivers Surprising News about Common Procedures for Elderly Patients

The statistics on healthcare spending on procedures for elderly patients are alarming. As much as 18% of a person’s lifetime medical expenses are spent during their last year of life. 30% of Medicare’s annual expenditures are spent caring for the 5% of recipients who will die during the same year.  One-third of that money isRead the Rest…


Transitions from SNF to Home Lead to High 30-Day Hospital Readmission Rates

The rates of hospital readmissions after transitioning from hospital to a long-term care facility have been under scrutiny for some time because of the high costs to Medicare and Medicaid. Now, 30-day readmission rates after transitions to home from LTCs are being looked at too. The results aren’t good. A study of 50,000 Medicare beneficiaries,Read the Rest…


Medicare Tracks ACOs Quality of Care

ACOs, networks of doctors and hospitals tasked with improving patient care while saving Medicare money, reported mixed rates of success in a February 2014 report that offered the first look at their effectiveness. Voluntary creation of Accountable Care Organizations (ACOs) is the most prominent way the Affordable Care Act attempts to provide higher-quality care toRead the Rest…


Affordable Care Act Q & As

It’s still too soon after implementation to have many questions raised by the Affordable Care Act answered definitively, and of course, debates in courts across the nation will likely change things. But, some of the details about how it’s impacting quality patient care are beginning to come into focus even as they raise more questions.Read the Rest…


New Bill Will Save Medicare $100 Billion and Improve Post-Acute Care

A recently drafted Bill known as the Bundling and Coordinating Post-Acute Care Act of 2014 (BACPAC) is an attempt to improve post hospitalist care for patients and save Medicare as much as $100 billion over 10 years. The fundamental idea is that Medicare would pay a lump sum for 90 days of post-acute care. Post-acuteRead the Rest…