How Skilled Nursing Facilities Need To Prepare For Value-Based Care

Electronic Health Reporter

The article How Skilled Nursing Facilities Need To Prepare For Value-Based Care appeared first on electronichealthreporter.com. Editorial long-term care Medicare fee-for-service skilled nursingThis article is copyrighted strictly for Electronic Health Reporter.

What Is the Patient Driven Payment Model: How Skilled Nursing Providers Can Get Ahead of PDPM

Electronic Health Reporter

The Patient Driven Payment Model (PDPM) is more than just a new name attached to Medicare payment reform. The shift from Resource Utilization Group (RUG) IV to PDPM moves the skilled nursing reimbursement model away from therapy provision as its main driver.

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Nursing homes and Covid-19 – defensiveness persists 

Aging in Place Technology Watch

Nursing homes – consternation, condemnation are words that rule the day. It must be tough to be focal points for nursing home policy these days. Even as a task force is being set up to focus on nursing homes, on the one hand, that seems positive.

Why It's Time to Embrace Telemedicine

eVisit

What’s this new thing called Telemedicine? For starters, it’s not new! I t’s more than 40 years old and was developed as a way to use improvements in communication technology to bring quality medical diagnoses and care to individuals in remote parts of the world.

Bipartisan bills in House, Senate seek to increase telehealth in nursing homes

Healthcare IT News - Telehealth

The Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2020, bipartisan legislation introduced in both the House and Senate, aims to enable more widespread use of telehealth in skilled nursing facilities.

New bill would codify Medicare reimbursement for telehealth services

Healthcare IT News - Telehealth

introduced new legislation this week that would provide for permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics. Butterfield, D-North Carolina, and Glenn Thompson, R-Pa.,

CMS plans to release list of 400 troubled nursing homes following Senate report

FierceHealthIT

The Centers for Medicare & Medicaid Services announced a plan to release the names of the 400 lowest-performing nursing homes

AHIMA and AHCA Partner To Train Skilled Nursing Facilities In Coding Ahead of Upcoming Reimbursement Overhaul

Electronic Health Reporter

1, 2019, the Centers for Medicare […]. The article AHIMA and AHCA Partner To Train Skilled Nursing Facilities In Coding Ahead of Upcoming Reimbursement Overhaul appeared first on electronichealthreporter.com. This article is copyrighted strictly for Electronic Health Reporter.

Telemedicine improves care, keeps patients in place at skilled nursing facility

Healthcare IT News - Telehealth

The skilled nursing sector has undergone a major transition over the past ten years. Because of shifting demographics and the challenges they place on hospitals, skilled nursing facilities are receiving patients who are struggling with more significant health concerns than in the past.

Medicare Reimbursement for Remote Monitoring Should Drive Adoption (What a long, strange trip it’s been….)

The cHealth Blog

The Centers for Medicare & Medicaid Services (CMS) released the 2018 Physician Fee Schedule about two weeks ago and there is at least one nugget in there that should speed the adoption of remote patient monitoring.

Florida healthcare executive convicted in $1.3B Medicare, Medicaid fraud scheme 

FierceHealthIT

The owner of several South Florida skilled nursing and assisted living facilities has been found guilty for his role in a $1.3 billion scheme to defraud Medicare and Medicaid—one of the largest in U.S. history.

OIG asks CMS to help improve reporting of abuse, neglect in nursing homes

FierceHealthIT

HHS recently released two documents that address the lack of reporting when it comes to incidents of abuse and neglect of Medicare beneficiaries in skilled nursing facilities (SNF

Medicare Opens the Door to Reimbursement for Remote Patient Monitoring

Digital Health Today

When CMS unveiled the first standalone reimbursement for Remote Patient Monitoring (“RPM”) by “unbundling” CPT Code 99091 in the 2018 Medicare Physician Fee Schedule , it opened the door to the widespread use of RPM services for patients and promised there was more to come.

What $285,000 Can Buy You in America: Medical Costs for Retirees in 2019

Health Populi

That retirement cost gap is the sticker-shock assumption that Medicare is going to cover all health care expenses in retirement.

CMS conducting 'comprehensive review' of nursing home oversight processes following OIG report

FierceHealthIT

The Centers for Medicare and Medicaid Services is undertaking a comprehensive review of its regulations and processes when it comes to ensuring safety and quality in nursing homes, CMS Administrator Seema Verma announced Monday. On the same day, HHS' Office of Inspector General released a report saying CMS needs to do more to address gaps in federal oversight of nursing home investigations in Oregon

CMS guidance aims to ease access to nursing home waivers for ACOs

FierceHealthIT

The Centers for Medicare & Medicaid Services is making it easier for accountable care organizations that accept downside risk to obtain waivers for a rule that requires a three-day inpatient stay before a referral to a nursing home

Do Medicare providers located at a Distant Site have to be hospital-based to provide services?

South Central Telehealth Resource Center

Q: Per Medicare regulations, do the providers at a distant site have to be hospital-based or can they be in a private setting – for example, a group of pulmonologists who want to create a telehealth system on their own? Also, all telehealth services must meet the Medicare established set of criteria for reimbursement. Click here to visit the Medicare Eligibility Analyzer site. To review CCHP information on Medicare, go to: [link]. Medicare

Medicare Told to Cover CGMs in Ruling

Insulin Nation

Medicare doesn’t typically provide coverage for continuous glucose monitors (CGMs), as insurors who oversee Medicare coverage have long argued that CGMs are a “precautionary” device rather than a “medically necessary” one. The Medicare-insuring contractor denied the claim.

More Evidence of Self-Rationing as Patients Morph into Healthcare Payors

Health Populi

Wolters Kluwer released a summary of a study this week, to be published in full in 2020, surveying 1,000 consumers (232 of whom had been a hospital inpatient in the past year) and 837 health care providers (a mix of physicians, nurses, and hospital administrators).

The Promise of Telehealth for Older People – the U-M National Poll on Healthy Aging

Health Populi

Health Populi’s Hot Points: I recently collaborated with HealthMine on a survey looking into Medicare Advantage members’ views of health and digital technology. But remember that the trusted relationship — for “now” — remains between the patient and the doctor, nurse and pharmacist.

The interoperability 'Golden Spike'

Morning eHealth

Modest Medicare telemedicine increase — Yelp 'beats' CMS at nursing home rating

HEART Act Targets Medicare Limits on Telehealth

American Well

the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. are on Medicaid and/or Medicare.

Health Is Social – The Social Determinants of Health at HIMSS19

Health Populi

Patients most-trust their clinicians, physicians and nurses, as safe places in which to have an honest SDoH discussion, compared with a health insurance representative. To mitigate SDoH risks for older Americans, Medicare has begun to pay for services that promote coordinated care.

Can Telemedicine Now Keep You out of a Nursing Home Later?

GlobalMed

The answer is enter a nursing home. Or be “stuck” as many people put it – as in the phrase, “I don’t want to be stuck in a nursing home.” Right now, about 25 percent of older adults will enter a nursing home at some point. Nursing home residency isn’t ideal for anyone.

CMS rolls back more Medicare, telehealth regs for providers working through pandemic

Henry Kotula

Other major changes are related to COVID-19 testing for Medicare and Medicaid beneficiaries. A written practitioner’s order is no longer needed for diagnostic testing for Medicare payment purposes. [link].

HEART Act Targets Medicare Limits on Telehealth

American Well

the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas. As of 2012, the average cost of a telehealth program was $1,600 per patient each year , versus $13,000 for home health services and $70,000 for nursing home care.

Thinking About Health Care One Year From the 2020 Presidential Election

Health Populi

Americans are roughly split — and/or equally confused — about the differences between three major health reform approaches: Medicare -for-All, improving the existing Affordable Care Act, or replacing the ACA with state-run health plans.

Changes to Medicare Advantage Plans Could Allow for Expansion of RPM Services in Senior Care

care innovations

And that means that “senior living companies that double as Medicare Advantage insurers” will be given the opportunity for reimbursement for new modes of care targeting patient with chronic conditions. Changes to Medicare Advantage Plans Designed to Reduce Rehospitalizations.

CMS’s Price Transparency Initiatives for 2020

BHM Healthcare Solutions

Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Here are 10 takeaways from the proposed rules: Medicare Outpatient Prospective Payment System. Medicare Physician Fee Schedule.

CMMI director: Home visits could be focus of upcoming Medicare demos

FierceHealthIT

To fill the physician gap, nurses and other medical professionals could join in this effort As founder of Landmark Health, Adam Boehler sees home visits as one way to move from volume to value.

Trump administration expands Medicare telehealth benefits for COVID-19 fight

Mobi Health News

CMS says the move will enable beneficiaries to get telehealth services in physician's offices, hospitals, nursing homes, rural health clinics – and their homes

Trump administration expands Medicare telehealth benefits for COVID-19 fight

Healthcare IT News - Telehealth

As promised , the Centers for Medicare and Medicaid Services has expanded its Medicare telehealth coverage during the coronavirus crisis, enabling more patients to get virtual care services from their doctors without having to travel to a healthcare facility.

Combating Opioid Overprescription

BHM Healthcare Solutions

Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Soon after the investigation spread to the Appalachian region, dozens of physicians, nurses, pharmacists and more were indicted for their alleged connections to 350,000 illegal prescriptions. Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries.

Payer Roundup—Trump rails against Medicare-for-all; Medicare paying nursing facilities more for rehabilitation

FierceHealthIT

The president attacked a Medicare-for-all proposal in an opinion column on Wednesday, and the senator who introduced that bill hit back. Plus, a study suggests for-profit nursing homes are sending patients to therapy at the end of their lives to make more money

Doctors Without Patients: ‘Our Waiting Rooms Are Like Ghost Towns’

Henry Kotula

The group’s four doctors and two nurse practitioners quickly adapted to the coronavirus pandemic, sharply cutting back clinic hours and switching to virtual visits to keep patients and staff safe. Dr. Gebhardt also works with Aledade to care for Medicare patients.

CPT Billing Codes reimburse for Care Coordination (Medicare)

Medicine and Technology

Let's face it: physicians spend a lot of time coordinating care for their older adult patients, especially when patients leave hospitals or nursing homes. Medicare is now accepting newly created Current Procedural Terminology (CPT) codes for care coordination to pay physicians for the management of patients who have recently been discharged from a hospital or skilled nursing facility. AMA billing CPT Medicare

Op-Ed: As a doctor, I use telemedicine. With the coronavirus threat, it could revolutionize healthcare

Henry Kotula

Instead, a neurologist would assess the patient on a mobile screen from far away, with local nursing staff and doctors aiding him or her. Physical exams are the bedrock of how doctors and nurses assess patients. [link].

CMS relaxes more rules around telehealth, allowing care across state lines

Healthcare IT News - Telehealth

The Centers for Medicare and Medicaid Services has temporarily suspended several regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the coronavirus pandemic.

Ensuring Safety and Quality in America’s Nursing Homes

CMS.gov

Ensuring Safety and Quality in America’s Nursing Homes. Administrator, Centers for Medicare & Medicaid Services. Nursing facilities. While we support and promote the private sector’s critical role in our health care system, CMS’ duty to monitor the safety of the nation’s hospitals, nursing homes, and other providers, is a unique governmental task which lies at the core of government’s role in health care. We’re also improving quality of life for nursing home residents.

Six Covid-19 Aging and Health Technology blog posts from May 2020

Aging in Place Technology Watch

We have been incredulous, watching older adults die alone in a nursing home , and then dying in many nursing homes. Here are six blog posts from a May unlike any previous: Could technology improve nursing homes? About those Covid-19 nursing home deaths.