Earlier this year, the Centers for Medicare and Medicaid Services (CMS) raised the possibility of moving forward with a proposed pre- or post-claim review demonstration program in up to four states in 2021 despite industry pushback. Since the initial announcement, CMS continues to push for advancement of the program. Stakeholders noted the implementation would increase the administrative burden already placed on providers dealing with staffing shortages and capacity issues due to the COVID-19 pandemic. Read Full Post

The Centers for Medicare and Medicaid Services (CMS) recently released the Inpatient Rehabilitation Facility (IRF PPS), for fiscal year (FY) 2022. The payment rule took effect October 1, 2021. Read Full Post

As the regulatory environment continues to shift, impacting health systems across the country, it is crucial to have all of the necessary tools and resources to successfully avoid or limit the impacts brought on by these trends – specifically denials. Read Full Post

Healthcare providers are experiencing higher rates of denials than ever before – making it crucial to have a partner with a proven track record of reducing denials through a trusted team of experts. Read Full Post

Recently, the Centers for Medicare and Medicaid Services (CMS) raised the possibility of moving forward with a proposed pre- or post-claim review demonstration program in up to four states in 2021 despite industry pushback. Stakeholders noted the implementation of this program would increase the… Read Full Post

In late 2019, the Centers for Medicare and Medicaid Services finalized the Physician Fee Schedule for this calendar year, which includes several updates and changes to the provision, payment and paperwork related to Medicare Part B Physical Therapy services. These changes included new rules that have already gone into effect earlier this year, and for new initiatives coming in 2021 and 2022. Read Full Post

A growing healthcare trend that will almost certainly ramp up in 2020 is “consumerism,” the concept that patients and their family members are taking even more ownership of care decisions based upon costs and their understanding of the full scope of options available to them based on research and trustworthy sources of information. In response, healthcare providers have been asked to respond with more price transparency and demonstrated quality outcomes. Read Full Post

Kindred Hospital Rehabilitation Services (KHRS) began working with our internal teams and partners in 2014 to prepare for the changes mandated through the IMPACT Act that would ultimately go into effect in 2019. In order to effectively transition from the long-used FIM tool to section GG, the IRF industry required a revised strategy with new tools, resources and training to succeed. In preparation for the changes to the new IRF-PAI system and new requirements, KHRS developed a comprehensive training and implementation plan to ensure a smooth transition for all of our hospital partners. Read Full Post

Trend to Watch: Healthcare Consolidation Aims to Close Gaps and Drive Value-Based Care In 2020, the continued – and growing – trend toward integrated production, including non-traditional partners, is helping to define an age of major transformation across the healthcare industry. While mergers and acquisitions between hospitals, health systems and physician practices may be waning, consolidation among unlikely partners has accelerated. These types of relationships include the ongoing integration between CVS and Aetna and the announced deal between Walmart and Amedysis. Read Full Post

Certificate of Need (CON) is a public policy tool which seeks to slow healthcare cost growth, avoid duplication of programs and services and ensure that new development meets the needs of the community. Nationally, only 12 states have no CON requirements. In Florida, the CON program was enacted in 1973 and applied to the building of new health centers or expansion of certain, complex medical services – including hospitals, nursing facilities, hospices and intermediate care facilities for the developmentally disabled. Read Full Post