The new health care law is cutting payments to Medicare Advantage plans. Republican lawmakers predicted that the cuts would lead insurers to increase premiums, reduce benefits or pull out of the program. But so far the dire predictions have not been borne out.
On average, the Obama administration said recently, Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and insurers expect their Medicare enrollment to increase by 10 percent.
Friday, November 25, 2011
Thursday, November 17, 2011
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Alliance: Sudden Medicare Cuts Reduce Staff and Quality of Skilled Nursing Care
Alyssa Gerace | November 15, 2011 | Comments (0)
More than a third of skilled nursing facilities are expecting to lay off staff in the wake of Medicare reimbursement rate cuts, affecting the quality of care given, according to a survey conducted by Avalere Health for the Alliance for Quality Nursing Home Care. However, the impact would be less severe if the cuts were phased in rather than implemented at once, says the Alliance.
“A gradual phase-in of the federal regulation—which has been done in the past for other provider sectors – can help alleviate the dislocation and disruption causing many facilities to warn of layoffs and other negative developments,” said Alan Rosenbloom, president of the Alliance, in a statement.
Operators are expecting to tighten their belts after federal regulation for an 11.1% reduction in Medicare reimbursements to SNFs went into effect Oct. 1, 2011, with plans to reduce staff, postpone renovations or facility expansions, and cut staff benefits—all components of quality of care.
“SNF operators are deeply concerned about the implications of this rule,” said Dan Mendelson, CEO of Avalere Health, in a statement. “The facilities we surveyed reported that they plan layoffs, deferrals of facility renovations, and wage and benefit reductions—and anticipate significant financial strain moving forward.”
More than a third of facilities, at 36.8%, said they expect to lay off direct service staff, including registered nurses, licensed practical nurses, and certified nursing assistants, while 37% said they will likely indefinitely postpone or cancel hiring new direct service staff. Approximately 20,000 layoffs could be the result of the regulation, the Alliance estimates.
Nearly a quarter of survey respondents, at 23.5%, said the Medicare cuts will delay or cancel opening new facilities or expanding existing facilities.
Just under 75% of facilities said they will be making changes in wage rates, including wage cuts or freezes, eliminations of bonus plans, or smaller starting salaries for new hires. Almost half of facilities plan to make changes in employee benefits, including reducing or eliminating contributions to 401(k) plans or health insurance premiums.
Shortly after the cuts were announced, Avalere Health released a study that found the new CMS regulation would reduce Medicare funding to the SNF sector by $79 billion in the next 10 years. The reduction comes on top of $29.4 billion in Medicare cuts enacted to fund healthcare reform, and a $16.8 billion Medicare payment reduction in 2010 regulation.
The possibility of further Medicare cuts looms in the near future as the Super Committee seeks to reduce the nation’s debt deficit.
View the survey results here.
Written by Alyssa Gerace
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Category: Senior Care
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« LTC Properties Acquires Skilled Nursing Facility for $17.5 Million
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Senior Housing Operators Work to Mitigate Impact of Medicare Cuts in Q4
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Shift Away From Nursing Home Care Reveals Challenges
In the past 10-plus years, there has been a trend away from nursing homes and to other, more home-like forms of long-term care for American seniors. Most say the shift is due to nursing homes’ high costs, but also some of the traditional qualities that nursing homes have represented over the years and the rise [...]
Senate Committee On Aging Exploring Ways to Modernize the Older Americans Act
Last week, the Senate Special Committee on Aging conducted a hearing on ways to further eldercare services through the reauthorization of the Older Americans Act (OAA). The current OAA programs provide assistance to over 10 million older adults by helping them to live independently in their communities through home care services, congregate and home delivered [...]
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June 1, 2011 |
Home
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Medicare/Medicaid
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Alliance: Sudden Medicare Cuts Reduce Staff and Quality of Skilled Nursing Care
Alyssa Gerace | November 15, 2011 | Comments (0)
More than a third of skilled nursing facilities are expecting to lay off staff in the wake of Medicare reimbursement rate cuts, affecting the quality of care given, according to a survey conducted by Avalere Health for the Alliance for Quality Nursing Home Care. However, the impact would be less severe if the cuts were phased in rather than implemented at once, says the Alliance.
“A gradual phase-in of the federal regulation—which has been done in the past for other provider sectors – can help alleviate the dislocation and disruption causing many facilities to warn of layoffs and other negative developments,” said Alan Rosenbloom, president of the Alliance, in a statement.
Operators are expecting to tighten their belts after federal regulation for an 11.1% reduction in Medicare reimbursements to SNFs went into effect Oct. 1, 2011, with plans to reduce staff, postpone renovations or facility expansions, and cut staff benefits—all components of quality of care.
“SNF operators are deeply concerned about the implications of this rule,” said Dan Mendelson, CEO of Avalere Health, in a statement. “The facilities we surveyed reported that they plan layoffs, deferrals of facility renovations, and wage and benefit reductions—and anticipate significant financial strain moving forward.”
More than a third of facilities, at 36.8%, said they expect to lay off direct service staff, including registered nurses, licensed practical nurses, and certified nursing assistants, while 37% said they will likely indefinitely postpone or cancel hiring new direct service staff. Approximately 20,000 layoffs could be the result of the regulation, the Alliance estimates.
Nearly a quarter of survey respondents, at 23.5%, said the Medicare cuts will delay or cancel opening new facilities or expanding existing facilities.
Just under 75% of facilities said they will be making changes in wage rates, including wage cuts or freezes, eliminations of bonus plans, or smaller starting salaries for new hires. Almost half of facilities plan to make changes in employee benefits, including reducing or eliminating contributions to 401(k) plans or health insurance premiums.
Shortly after the cuts were announced, Avalere Health released a study that found the new CMS regulation would reduce Medicare funding to the SNF sector by $79 billion in the next 10 years. The reduction comes on top of $29.4 billion in Medicare cuts enacted to fund healthcare reform, and a $16.8 billion Medicare payment reduction in 2010 regulation.
The possibility of further Medicare cuts looms in the near future as the Super Committee seeks to reduce the nation’s debt deficit.
View the survey results here.
Written by Alyssa Gerace
Rate This
Email This Post Print This Post
Category: Senior Care
Subscribe
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Comments
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Enter text right here!
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« LTC Properties Acquires Skilled Nursing Facility for $17.5 Million
Census: Older Adults Sharing Homes Longer With Children »
.
.
Free Email Subscriptions:
Senior Housing Daily
Senior Housing Weekly
Sponsored By
Popular
Recent
Comments
Archives
.
Nuns Go Bankrupt Over Chicago Senior Living Facility, Blame Recession
Technology Must Become High Priority for Senior Housing Operators
Brandywine Acquires Four Assisted Living Communites for Undisclosed Sum
Grubb & Ellis Healthcare REIT Under New Sponsorship, Will Change Name
Senior Housing Operators Work to Mitigate Impact of Medicare Cuts in Q4
.
.
.
.
Shift Away From Nursing Home Care Reveals Challenges
In the past 10-plus years, there has been a trend away from nursing homes and to other, more home-like forms of long-term care for American seniors. Most say the shift is due to nursing homes’ high costs, but also some of the traditional qualities that nursing homes have represented over the years and the rise [...]
Senate Committee On Aging Exploring Ways to Modernize the Older Americans Act
Last week, the Senate Special Committee on Aging conducted a hearing on ways to further eldercare services through the reauthorization of the Older Americans Act (OAA). The current OAA programs provide assistance to over 10 million older adults by helping them to live independently in their communities through home care services, congregate and home delivered [...]
.
June 1, 2011 |
Saturday, November 5, 2011
policy that allows hospitals to avoid admitting elderly people with chronic ailments as inpatients
..
(Reuters) - A group of Medicare patients and their families sued the Obama administration on Thursday, saying they were deprived of coverage by the government health plan because of a policy that allows hospitals to avoid admitting elderly people with chronic ailments as inpatients.
The plaintiffs, who are seeking class-action status for the case, asked a U.S. district court in Hartford, Connecticut, to stop Health and Human Services Secretary Kathleen Sebelius from authorizing doctors to place Medicare hospital patients on "observation" status rather than admitting them for inpatient care.
The observation services policy, meant to apply mainly for hospital stays of no more than 48 hours, is instead being used to keep the elderly on outpatient status for longer stays including some lasting up to a week, according to court documents.
The plaintiffs, aged 74 to 96, suffered multiple health problems including cancer, Parkinson's disease and arthritis. Each entered the hospital as an emergency patient, usually after a fall, but remained on observation status for days of full hospital service.
None received hospital coverage under Medicare Part A for their stays. Instead they were relegated to the Part B section of the federal program that covers visits to doctors' offices and other outpatient facilities.
'SEVERE FINANCIAL PROBLEMS'
As a result, they and their families incurred medical charges as high as $30,000 for skilled nursing care, drugs and other costs that Medicare does not cover unless a patient has been admitted to a hospital for at least three days.
The policy is meant to protect hospitals from Medicare penalties for admissions made in error. But the incidence of observation status has increased sharply in recent years with the advent of federal healthcare reform and heightened scrutiny of Medicare spending, according to Medicare patient advocates.
The result can be tens of thousands of dollars in medical costs for beneficiaries, who do not qualify for Medicare hospital coverage while on observation status.
"This causes severe financial problems for beneficiaries and their families," said Judith Stein, executive director of the Center for Medicare Advocacy.
She cited federal statistics showing that tens of thousands of Medicare beneficiaries are placed on observation status in U.S. hospitals each year.
Stein's Connecticut group and the Washington-based National Senior Citizens Law Center filed the federal case on behalf of two Medicare beneficiaries in their 90s and the families of five others who have died.
Medicare advocates have filed individual lawsuits in observation cases for years but have not sought class-action status until now. A class action suit permits a large number of people to sue collectively.
Democrats have introduced legislation to address the issue in both houses of Congress. But the bills have gone nowhere.
"We've decided we can wait no longer and have turned to the courts for fairness," Stein said.
The lawsuit claims the HHS policy allowing observation status is illegal under federal law and has deprived plaintiffs of their proper Medicare benefits.
A spokesman for the Centers for Medicare and Medicaid Services, the federal agency that oversees the programs, declined to comment on the lawsuit. The American Hospital Association, a Washington-based industry trade group, also had no comment on the litigation.
(Editing by Xavier Briand)
..
(Reuters) - A group of Medicare patients and their families sued the Obama administration on Thursday, saying they were deprived of coverage by the government health plan because of a policy that allows hospitals to avoid admitting elderly people with chronic ailments as inpatients.
The plaintiffs, who are seeking class-action status for the case, asked a U.S. district court in Hartford, Connecticut, to stop Health and Human Services Secretary Kathleen Sebelius from authorizing doctors to place Medicare hospital patients on "observation" status rather than admitting them for inpatient care.
The observation services policy, meant to apply mainly for hospital stays of no more than 48 hours, is instead being used to keep the elderly on outpatient status for longer stays including some lasting up to a week, according to court documents.
The plaintiffs, aged 74 to 96, suffered multiple health problems including cancer, Parkinson's disease and arthritis. Each entered the hospital as an emergency patient, usually after a fall, but remained on observation status for days of full hospital service.
None received hospital coverage under Medicare Part A for their stays. Instead they were relegated to the Part B section of the federal program that covers visits to doctors' offices and other outpatient facilities.
'SEVERE FINANCIAL PROBLEMS'
As a result, they and their families incurred medical charges as high as $30,000 for skilled nursing care, drugs and other costs that Medicare does not cover unless a patient has been admitted to a hospital for at least three days.
The policy is meant to protect hospitals from Medicare penalties for admissions made in error. But the incidence of observation status has increased sharply in recent years with the advent of federal healthcare reform and heightened scrutiny of Medicare spending, according to Medicare patient advocates.
The result can be tens of thousands of dollars in medical costs for beneficiaries, who do not qualify for Medicare hospital coverage while on observation status.
"This causes severe financial problems for beneficiaries and their families," said Judith Stein, executive director of the Center for Medicare Advocacy.
She cited federal statistics showing that tens of thousands of Medicare beneficiaries are placed on observation status in U.S. hospitals each year.
Stein's Connecticut group and the Washington-based National Senior Citizens Law Center filed the federal case on behalf of two Medicare beneficiaries in their 90s and the families of five others who have died.
Medicare advocates have filed individual lawsuits in observation cases for years but have not sought class-action status until now. A class action suit permits a large number of people to sue collectively.
Democrats have introduced legislation to address the issue in both houses of Congress. But the bills have gone nowhere.
"We've decided we can wait no longer and have turned to the courts for fairness," Stein said.
The lawsuit claims the HHS policy allowing observation status is illegal under federal law and has deprived plaintiffs of their proper Medicare benefits.
A spokesman for the Centers for Medicare and Medicaid Services, the federal agency that oversees the programs, declined to comment on the lawsuit. The American Hospital Association, a Washington-based industry trade group, also had no comment on the litigation.
(Editing by Xavier Briand)
..
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