Aug 17, 2021 | Hospitals, Inpatient, Payers
CMS published the final rules for the FY 2022 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospitals (LTCH) Prospective Payment System (PPS). The IPPS applies to approximately 3,200 acute care hospitals. The finalized increase in IPPS operating payment rates is +2.5% or ~$3.2 billion. The LTCH PPS rule applies to approximately 360 LTCHs. The finalized increase to LTCH payments is +1.1% or $52 million. Click to read more.
Aug 13, 2021 | Managed Care Friday
5: The number of new states where Aetna is entering the ACA marketplace in 2022, including Nevada, Missouri, Texas, Florida, and North Carolina. Meanwhile, HCSC will expand its Medicare Advantage (MA) footprint to an additional 90 counties next year, which the company says is its largest MA expansion ever. Per Member Per Month, And Then Some: A Medicaid managed care plan in Kansas is playing Oz by setting up a series of multi-level payment per month models for youth behavioral health care. In one design, you can get a $1 PMPM for doing follow up calls within 7 days of IP discharge, $20 for...
Aug 10, 2021 | Behavioral, Inpatient Rehab (IRF), Medicare, Post-Acute Care, Substance Abuse
Inpatient Rehab Facility (IRF): CMS's FY2022 final rule for the IRF payment system finalizes a +1.9% update and does not include any major policy changes. Click to read more.
Aug 10, 2021 | Behavioral, Inpatient Psych, Medicare
Inpatient Psychiatric Facility (IPF): CMS's FY2022 final rule for the IPF payment system is projected to increase IPF payments by +2.1% or $80M in 2022. Click to read more.
Aug 10, 2021 | Medicare, Post-Acute Care, Skilled Nursing Facilities (SNF)
Skilled Nursing Facility (SNF): CMS increases FY2022 Medicare payments to SNFs by the annual market basket update of +1.2%. Click to read more.
Aug 10, 2021 | Hospice, Medicare
Hospice: CMS increases FY2022 Medicare payments to hospices by +2.0% and implements minimal policy changes. Click to read more.
Aug 6, 2021 | Managed Care Friday
24: No, not Kiefer Sutherland’s best performance but the portion of seniors who fall due to dehydration, end up in rehab, then fall within 6 months for the same reason based on a study of a cohort of patients with 6 common traits – undiagnosed dementia but significant short-term memory issues, live by themselves, widowed, limited caregiver support, limited social circles and no mention of “daughter” or “daughter or in law” in the medical record. The study, which we did in collaboration with 3 rehab centers in Boston’s north shore, is based on 292 admissions between 2019 and today related to...
