Headlines

CMS To Increase Drug Price Transparency

The Trump Administration has finalized adjustments to Medicare Advantage and Medicare Part D to ensure patients have greater transparency in the cost of prescription drugs, along with improved visibility to their options. Under this new rule, the Explanation of Benefits document that Part D enrollees receive should now include notice of drug price increases as

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SNF Star Rating Correlates To Profitability

Skilled Nursing Facilities are discovering that investing in their Staffing Star rating doesn’t necessarily lead to profitability. Rather, SNFs would serve better by focusing their attention on their survey and quality ratings, which show the biggest impact to their CMS five-star rating. This Star rating is indicative of the operating margin a SNF should expect

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SNF $887 Million Boost With CMS Proposed PPS Update

Through CMS’s proposed update to the prospective payment system (PPS) for the federal fiscal year 2020, SNF’s would see an increase in Medicare payments of $887 million.2020 marks the implementation of the Patient-Driven Payment Model (PDPM), which focuses on clinical conditions as opposed to the volume of care provided. Under this model, CMS placed a

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New Strategy Could Overhaul Fee-For-Service

The U.S. Department of Health and Human Services (HHS) revealed new voluntary programs that could overhaul the fee-for-service model, set to launch at the beginning of 2020. The first model is targeted towards small primary-care practices, while larger practices and health systems have other choices such as “professional” and “geographic” options. For more on this,

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CMS Chief Verma’s “Comprehensive review” of Nursing Home Safety and Quality Standards

CMS Chief Seema Verma recently announced a “comprehensive review” of safety and quality standards for nursing homes. In this post, Verma highlights changes that have already been made, including stricter staffing requirements as well as aligning reimbursements with performance. Verma’s post reminds that the federal government will continue to overhaul its regulations for nursing homes

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Skilled Nursing Facilities Sudden Star Ratings Decrease

Approximately 36% of SNFs experienced a drop in stars this week according to the American Health Care Association (AHCA). With many providers losing one or more stars in quality, many SNFs trace this star decrease back to nurse staffing which has the greatest impact on quality. Quality has been a major focus as Centers for

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