Category: Medicare and Medicaid

Extendicare to Pay $38 Million in Largest Failure-of-Care Settlement in DOJ History

Extendicare Health Services Inc., which operates 146 skilled nursing facilities in 11 states, has agreed to pay $38 million to settle claims that it billed Medicare and Medicaid for “substandard” nursing services, the Department of Justice (DOJ) announced late last week.  Extendicare and its subsidiary Progressive Step Corporation (ProStep) allegedly billed the federal government for… Read More »

President Obama Says Yes to Post-Acute Care Law

President Obama signed into law a bill to standardize data used by post-acute care providers Monday, which aims to increase quality, transparency and accountability to the post-acute care industry. The Improving Medicare Post-Acute Care Transformation Act, or IMPACT Act (H.R. 4994), received support from both Democrats and Republicans, and received praise from multiple health care… Read More »

Three More Pioneer ACOs Call it Quits

Two years after the Centers for Medicare & Medicaid Services (CMS) launched its Pioneer Accountable Care Organization (ACO) model, the initiative is now down to about 60% of its original participants following the exit of three health systems last week. The latest ACOs to leave the CMS program—Franciscan Alliance in Indianapolis; Genesys PHO in Flint,… Read More »

CMS: Medicare ACOs Have Saved $372 Million

With many eyes on Accountable Care Organizations (ACOs) and their role in the future of senior care, the The Centers for Medicare & Medicaid Services (CMS) shed some light Tuesday on the performances of its Pioneer ACOs to date. According to quality and financial performance results compiled by CMS, Medicare ACOs have improved patient care… Read More »

Justice Department Zooms in on Elder Financial Abuse

Financial exploitation of the elderly is a nearly $3 billion business annually, depleting the resources of many, including businesses and the Medicare and Medicaid programs. In hopes of curbing this fraud, the U.S. Department of Justice (DOJ) launched the Elder Justice website this week. “The launch of the Elder Justice website today marks another milestone… Read More »

Another Pioneer ACO Calls It Quits, Citing Regional Challenges

A 10th Medicare Pioneer accountable care organization (ACO) is throwing in the towel, following other ACOs that previously left in favor of other Medicare saving opportunities or dropped out of the ACO program altogether.  Sharp HealthCare, a five-hospital system in San Diego, announced it was leaving the Pioneer ACO program in its third-quarter financial statement. Sharp… Read More »

Maine Rallies for Totally New Approach to Senior Care

Maine seniors, along with affordable housing, home care, general contractors and other aging services stakeholders are rallying around a comprehensive package of proposals that aim to strengthen the state’s aging in place resources that go beyond traditional assisted living and nursing homes.  Mark Eves (D-North Berwick), speaker of Maine’s House of Representatives, last week unveiled… Read More »

House Calls Cut Medicare Costs 17%, Still in Vogue for Senior Care

A popular arrangement in the past where physicians provided care to patients within the comfort of their own homes, house calls haven’t completely gone out of style just yet, especially given their proven effectiveness in saving money for healthcare providers and federal programs alike, a recent study finds. Researchers with MedStar Washington Hospital Center, a 926-bed teaching and… Read More »

Why Home Health Care’s Growth Will Falter

As the desire to age in place increases alongside the aging population, the home health care sector will create nearly a million new jobs by 2022, far outpacing the growth of other major occupations in the U.S., The Wall Street Journal writes in a recent article.  The U.S. Department of Labor predicts the profession will… Read More »

CMS Oversight Creates ‘Unnecessary Burden’ for Providers

A government watchdog agency is calling for more oversight from the Centers for Medicare & Medicaid Services (CMS), which may “create an unnecessary burden” on some senior housing providers, a report finds.  The U.S. Government Accountability Office (GAO) found that CMS has not been effectively tracking postpayment Medicare claims to ensure the same claim isn’t… Read More »

Nursing Homes Rank as Worst Setting For End-of-Life Care

Reported care experiences are typically worse in the nursing home setting, according to the latest results of a survey by the Centers for Medicare & Medicaid Services (CMS). The Hospice Experience of Care Survey measured experiences of patients and their caregivers in three hospice settings: nursing home (including both skilled and regular nursing facilities), home… Read More »