Kissito Healthcare Mentioned in White Paper Regarding Bundled Payments
August 7, 2009 by admin
Filed under News & Events
While bundled payments is not a new concept in the discussion of healthcare reform, it found its way back to the front burner in December 2008 when the US Congressional Budget Office (CBO) proposed new ways to reduce federal healthcare spending to the House and the Senate.
Introduced nearly 30 years ago, bundled payments would essentially provide one payment to Acute Care Hospitals (ACHs) for both acute and post acute services and allow the ACH to determine the amount of post acute care a patient needs and the most cost effective care provider. Under this scenario, the CBO estimates a $0.7 billion reduction in federal outlays between 2010 and 2014 and by 2019 they estimate a reduction of almost $19 billion.
The reintroduction of the concept raises many questions for ACHs, long term acute care hospitals (LTACHs), home health agencies, skilled nursing facilities (SNFs), and inpatient rehabilitation facilities (IRFs) and how they will be reimbursed for treating Medicare recipients. Also questioning this potential manner of reform are the lawmakers.
In a recent white paper entitled “To Bundle or Not To Bundle: Lawmakers Explore the Question,” released by three attorneys at McGuire Woods, LLP, Jason S. Greis, R. Brent Rawlings, and J. Brian Jackson explore the questions that the implementation of bundled payments raise. The three comprehensively explain the concept, its history, and how it would affect the various types of acute and post acute facilities from the time of implementation through 2019 when the reform measure will reach the outcome envisioned by the CBO.
They further investigate the questions industry leaders are raising, the pros and cons of the option and what companies are doing now in preparation for the proposed legislation. An interview with Tom Clarke, President & CEO of Kissito Healthcare resulted in the explanation that “[s]ome organizations have already begun planning for the bundling trend by creating integrated post-acute care and senior living campuses with a full array or long-term care services, or by developing post-acute care facilities capable of catering to more acutely ill patients in more cost-effective settings.” Kissito Post Acute is one of said organizations in that its “SNF facilities provide ventilator weaning programs, which are commonly found in LTACHs, while achieving comparable clinical outcomes and Medicare costs savings.”
Kissito Post Acute, a division of Kissito Healthcare, prides itself on remaining patient-centered and physician-driven. Existing for the care and betterment of human life, Kissito Post Acute realizes the current paths patients take from hospital to home and redefines that, attempting to eliminate many of the unnecessary trips to various types of facilities. Their Collaborative Patient Care Model™ fosters the best environment for successful outcomes. This unique, industry-leading approach involves partners in a cohesive team that enables patients to return to their lives and function at the highest level.
Kissito Alerts May 18
May 18, 2009 by admin
Filed under Healthcare Alerts
Source: Health Care Finance News
Title: Hospital advocates address delivery system reform
Date: 5/18/09
URL: www.healthcarefinancenews.com/news/hospital-advocates-address-delivery-system-reform
- The AHA supports proposals to develop a comprehensive strategy to address workforce shortages, redistribute unused graduate medical slots to increase access to primary care and ban certain physician referrals to a hospital in which the physician has an ownership interest.
- Premier endorsed value based purchasing as a tool that should be applied not only to existing Medicare models but also to the longer term approaches such as bundled payments and the creation of accountable care Organizations.
Source: Health Care Finance News
Title: CMS extends timeline for medicare secondary
Date: 5/18/09
URL: www.healthcarefinancenews.com/news/cms-extends-timeline-medicare-secondary-payer-reporting
- CMS has extended its implementation schedule for new Medicare Secondary Payer reporting requirements under the Medicare, Medicaid and SCHIP Extension Act of 2007.
- The requirements are intended to ensure that the Medicare program does not pay for a beneficiary’s care when another insurer has primary responsibility.
- Organizations subject to the provisions can register for reporting through Sept. 30 and pre-test their electronic reporting from July 1, 2009 through May 30, 2010.
Source: Health Care Finance News
Title: Analysis: home health care for chronic patients saves medicare $1.71B
Date: 5/14/09
URL: www.healthcarefinancenews.com/news/analysis-home-healthcare-chronic-patients-saves-medicare-171b
- Patients with diabetes, chronic obstructive pulmonary disease or congestive heart failure who used home health care within three months of discharge from a hospital cost the program 1.71B less than those who used other forms of post acute care over a two years period.
- About 8.9% of Medicare fee-for-service beneficiaries currently used home health services.
- Approximately 86% of the Medicare population has one chronic condition, 66% have two or more and 40% have three or more.
- Avalere estimated that if all chronic care patients in the study used home health care rather than post acute care, Medicare could have spent 1.77B less over the 05-06 period.
Source: Health Care Finance News
Title: Congress promises obama health reform legislation by july 31
Date: 5/14/09
URL: www.healthcarefinancenews.com/news/congress-promises-obama-health-reform-legislation-july-31
- Last night Obama said Congress has promised to have comprehensive health care reform legislation passed by July 31.
- SFC leaders said Congress has not yet begun to tackle the most difficult parts of the health care debate, including how to fund the reform, the destiny of the employer health care tax exclusion and a potential national health plan to compete with private market.
Sebelius and DeParle said they are spending much of their time negotiating with Congress to promote the president’s reform plans
Kissito Alerts May 13
May 18, 2009 by admin
Filed under Healthcare Alerts
Source: McKnights
Title: New injection of concern medicare part a to become insolvent in 8 years, report says
Date: 5/13/09
- According to a new study by the Social Security and medicare Boards of trustees issued Tues, if trends continue, the Medicare Part A fund will become insolvent in 2017.
- As recently as 2003, the fund was expected to last until at least 2026. In 2004, the trustees revised that estimate and predicted the fund would run dry in 2019. Late last year, CMS projected that the program could go broke sometime between 2016 and 2018.
- Medicare Parts B and D are expected to remain in relatively good shape in the future, however, about one quarter of Part B enrollees will be subject to unusually large premium increases in the next two years.
Source: McKnights
Title: Nursing home groups suggest one billion medicare cuts could cost even more
Date: 5/13/09
- Nursing home reps released a report stating that cuts could carry additional billions of dollars in unintended costs and consequences for both patients and providers.
- Costs include more than $3.6 B in lost business activity and labor income.
Source: McKnights
Title: CMS released draft version of MDS 3.0 for nursing homes
Date: 5/12/09
- On Monday, CMS posted a draft version of the new MDS 3.0 for nursing homes.
- The final version is slated for release in oct. 2009 and will include the item set, data specifications and RAI manual.
- Questions and Comments on draft version should be sent to MDS30Comments@cms.hhs.gov
Source: Health Care Finance News
Title: Report: Pushing health care into digital age could save trillions
Date: 5/12/09
URL: www.healthcarefinancenews.com/news/report-pushing-healthcare-digital-age-could-save-trillions
- Automating the nation’s health care system could save the government nearly $600 B in spending over the next decade and $9 T over the next 25 years.
- Health reform will spark a productivity boom in health care.
- Productivity growth can cut in half the rise in projected Medicaid and Medicare spending.
- Health reform is entitlement reform.
Examples of poor health care are: failure of chronic care management, lack of performance data, insufficient competition in insurance, ineffective health system design, needless administrative complexity, and inappropriate end-of-life care.
Kissito Alerts May 11
May 14, 2009 by admin
Filed under Healthcare Alerts
Source: Health Care Finance News
Title: Obama, health care groups to focus on cost control
Date: 5/11/09
URL: www.healthcarefinancenews.com/news/obama-healthcare-groups-focus-cost-control
- Several prominent health care groups to meet with President Obama to announce plan to cut health care costs by $2 T over 10 years.
- Details on cost savings remain sketchy but groups are expected to subscribe to reducing the rate of growth in spending by 1.5% a year to achieve the savings.
Source: Health Care Finance News
Title: Sebelius launches office of health reform
Date: 5/11/09
URL: www.healthcarefinancenews.com/news/sebelius-launches-office-health-reform
- HHS Sec. Kathleen Sebelius launched on Monday the new HHS Office of Health Reform.
- Sebelius says “the HHS of Health Reform and the White House Office of Health Reform will work in tandem to advance legislation and take immediate actions to cut costs, assure quality and affordable health care for all Americans and guarantee Americans choose their doctor and their health plan.
- Jeanne Lambrew will head the Office of Health Reform.
Source: McKnights
Title: Long term care providers oppose post acute care payment bundling, medicare regulation in obama’s budget
Date: 5/11/09
- AHCA,NCAL,AQNHC say certain provisions in the budget would undermine efforts to create healthcare jobs and provide services for seniors.
- Bundling together payments for post acute services “could lead to unintended, negative consequences for elderly beneficiaries, front line care staff, and the entire post acute and long term care sector.”
- The groups also oppose a Medicare regulation that would cut senior’s Medicare funding by approximately $840 M in FY 2010.
Source: Medical News Base
Title: CMS announces series of proposed regulations including payment cuts
Date: 5/9/09
- CMS announced a series of proposed regulations, including a proposal to reduce Medicare payments for inpatient hospital care by 0.5% in FY 2010.
- Proposed cut is primarily the result of adjustments for excessive payments to hospitals in past years due to coding mistakes.
- CMS said that total adjustments will be about 8.5%, which would necessitate cuts of 6.6 percentage points combined in FY 2011 and FY 2012.
- Cuts to SNFs in FY 2010 will be 1.2%, or $390 M, compared with FY 2009 payments.
- Payments to long term care hospitals will increase by 2.4%
Kissito Alerts May 8
May 14, 2009 by admin
Filed under Healthcare Alerts
Source: McKnights
Title: Obama proposes $17 B in budget cuts, programs for the elderly and poor threatened
Date: 5/8/09
- On Thurs, Obama proposed $17B in budget cuts for both discretionary spending and entitlement programs, including Medicare and Medicaid.
- White House Budget Director Peter Orszag says more budget cuts are needed “especially curbing the growth of the Medicare and Medicaid health programs for the elderly and the poor.”
Source: Health Care Finance News
Title: Health care employment grows in april
Date: 5/8/09
URL: www.healthcarefinancenews.com/news/health-care-employment-grows-april
- Employment in the U.S. health care sector grew by 17,000 jobs in April.
- Job gains in health care have averaged 17,000 per month thus far in 2009, down from an average of 30,000 per month during 2008.
Source: Health Care Finance News
Title: Bill introduced to improve access, reduce physician shortage
Date: 5/8/09
URL: www.healthcarefinancenews.com/news/bill-introduced-improve-access-reduce-physician-shortage
- The “Resident Physician Shortage Reduction Act of 2009″ would, if passed, increase the number of Medicare-supported training positions for medical residents by 15%.
- The new legislation would redirect unused training slots and increase the cap by 15% to hospitals seeking to expand existing programs or establish new programs.
- The bill would also change existing rules so residents can be trained in non-hospital settings such as physician offices, community health centers, and other ambulatory care sites.
Source: Health Care Finance News
Title: White house budget bumps up hhs spending by $63B
Date: 5/7/09
URL: www.healthcarefinancenews.com/news/white-house-budget-bumps-hhs-spending-63
- President Obama’s budget indicates $879 B will be set aside for DHHS, an estimated $63B increase over FY 2009.
- The budget calls for improving efficiencies and bringing down costs in Medicare and medicaid reform, as well as cracking down on fraud.
- The president is recommending 121 budget cuts that would save $17B next year; included is the elimination of federal subsidies for health insurance companies through Medicare.
Kissito Alerts May 6
May 8, 2009 by admin
Filed under Healthcare Alerts
Source: McKnights
Title: Obamas fiscal year 2010 budget to push for more oversight of medicare, medicaid
Date: 5/6/09
- Details of President Obama’s budget proposal for FY2010 will be unveiled this Thursday.
- The president’s “program integrity” measure would allocate $13.7B over the next 5 years to increase oversight of Medicare, Medicaid and Social Security and has sparked interest.
Source: PR Inside
Title: LTAC hospital legislation introduced in us house
Date: 5/5/09
URL: www.pr-inside.com/ltac-hospital-legislation-introduced-in-r1228720.htm
- Last week the Medicare Long Term Care Hospital Improvement Act of 2009 (H.R. 2124) was introduced in the House.
- H.R.2124 protects patient access to care in LTAC hospitals while federal regulators and the private sector work towards development of additional facility and patient criteria and while Congress undertakes comprehensive health care reform.
- H.R. 2124 provides for a 2 year extension of certain LTAC hospital provisions found in the MMSEA.
Source: MedPage Today
Title: No sgr overhaul likely for early years of health care reform
Date: 5/5/09
URL: www.medpagetoday.com/washington-watch/washington-watch/14046
- Sen. Max Baucus says wholesale change of Medicare’s SGR system is unlikely in early years of change reform.
- Baucus says the SGR will be patched up those first three years and after that they’ll modify it and let some of the reduction in SGR match the curve, but then physician will be compensated by cost sharing gains received from other reforms; however that is just a proposal.
Kissito Alerts May 7
May 8, 2009 by admin
Filed under Healthcare Alerts
Source: McKnights
Title: Senate special commission on aging addresses medicare, medicaid fraud in special hearing
Date: 5/7/09
- The US Senate Special Commission on Aging met Wed. to discuss prevention of Medicare and Medicaid fraud, which costs taxpayers more than $60 B a year.
- Reps from the Southern District of Florida told the commission that their district prosecuted 245 individuals in 2008 for defrauding Medicare and medicaid of nearly $800M.
- Recommendations for reducing fraudulent spending include: expand the use of the medical home model, provide Medicare beneficiaries with cash incentives to maintain a healthy lifestyle, provide seniors on Medicare with a unique i.d number, independent of their social security number, and allow seniors to travel to another city to receive non-emergency surgery if that facility will charge the govt. less.
Source: McKnights
Title: Proposed bill could eliminate nursing home fines in illinois
Date: 5/7/09
- The Illinois state legislature is considering a controversial bill that would allow for the reduction, or in some cases, elimination of fines against nursing homes.
- Instead of paying money to the state in the event of a care-related violation, fines would be reduced or eliminated, providing the money instead goes toward the problem that led to the fine.
Source: Health Care Finance News
Title: Republican leader pushes state-level health reform
Date: 5/7/09
URL: www.healthcarefinancenews.com/news/republican-leader-pushes-state-level-health-reform
- Sen. Orrin Hatch (R-Utah) expressed concerns with democrat plans to give the government more power in health care.
- Hatch believes different states have different needs and each state knows what is best for their situation.
Source: Health Care Finance News
Title: VA outsources management of state medicaid program
Date: 5/7/09
URL: www.healthcarefinancenews.com/news/va-outsources-management-state-medicaid-program
- The VA Dept of Medical Assistance Services has signed a five year, $84 M contract with a vendor to manage the state’s Medicaid program.
- Affiliated Computer Services, Inc. will provide fiscal agent and provider enrollment services for the Medicaid Management Information System.
- Specific improvements include facilitating online provider enrollment and a web portal, which will give providers 24/7 point-of-access for claims entry, prior authorizations, retrieval of recipient eligibility, download of remittance advices and messaging.
Kissito Alerts April 30
May 1, 2009 by admin
Filed under Healthcare Alerts
Source: McKnights
Title: Weak economy forces nursing homes to freeze jobs, delay infrastructure projects, study finds
Date: 4/30/09
- A new study shows that nursing homes restricted access to capital is causing facilities to renegotiate supplier contracts, freeze jobs and hold off on wage increases, and delay infrastructure projects.
Source: McKnights
Title: Congress passes 3.4T budget blueprint
Date: 4/30/09
URL: www.mcknights.com/congress-passes-34-budget-blueprint/article/131620/?DCMP=MCK_Daily
- The House and Senate approved a $3.4T federal budget that would allow Congress to pass health care reform legislation without Republican opposition.
- Health care legislation would be permitted to pass with 51 votes in the Senate instead of the usual 60.
Source: The Commonwealth Fund
Title: Ensuring accountability: how a global fee would improve hospital care and generate savings
Date: 4/29/09
URL: www.commonwealthfund.org/Content/From-the-Pres/2009/Ensuring-Accountability.aspx
- Offering a “global fee” that covers a bundle of “best practice” services for hospitalization and 30-day post-hospital care has great potential to improve care, reduce complications, and generate savings to finance health reform.
- The Commonwealth Fund Commission also recommends applying new payment methods to acute-care episodes to encourage hospitals and other providers to collaborate in developing the capacity to provide high quality and efficient care for their patients.
- Offering a bundled acute payment would allow spending to decrease over time as efficiency savings were shared between Medicare and providers.
Source: Bio-Medicine
Title: National long term care leaders praise overall baucus health reform effort, express specific concerns moving forward
Date: 4/29/09
- Bruce Yarwood, President and CEO of the AHCA/NCAL, and Alan G. Rosenbloom, President of the Alliance for Quality Nursing Home Care, released a statement yesterday.
- The groups commend Senators Baucus and Grassley for pursuing a thoughtful, deliberative, inclusive approach to the sweeping health care policy reforms that will impact seniors for years to come.
- The groups urge the committee to consider the need to address long term care delivery system reform.
Source: The Hill
Title: Hospitals sit front and center in health care debate
Date: 4/28/09
URL: www.thehill.com/business–lobby/hospitals-sit-front-and-center-in-health-debate-2009-04-28.html
- Hospitals are the physical and figurative center of the healthcare delivery system in American communities and with at least one in every congressional district their political reach is wide.
- AHA President and CEO Rich Umbdenstock says the things that trouble hospitals about health care reform include worry that any new federal health program would use its clout to pay cut-rate fees, which would give private insurance companies ammunition to do the same.
- Bundle payments would reduce hospital incomes and readmission penalties would cut Medicare payment rates.
Kissito Alerts April 29
April 29, 2009 by admin
Filed under Healthcare Alerts
Source: Health Care Finance News
Title: Sebelius first order of business: swine flu, then reining in health care costs
Date: 4/29/09
- After Sebelius was sworn in, President Barack Obama cited the importance of making health care affordable. He also mentioned food safety and the swine flu crisis.
Source: McKnights
Title: Congress poised to vote on budget resolutions
Date: 4/29/09
URL: www.mcknights.com/congress-poised-to-vote-on-budget-resolutions/article/131548/?DCMP=MCK_Daily
- Democrats in Congress Monday nights settled on a $3.5 T budget plan that would allow for the reconciliation process for health care reform.
- The budget also includes funding for clean energy and other domestic programs, is set to take effect on Oct. 1.
Source: Medical News Today
Title: NCSL urged to back new ahca-ncal-alliance medicare post acute and long term care reform plan
Date: 4/28/09
URL: http://www.medicalnewstoday.com/articles/147737.php
- AHCA and NCAL turned their attention to how the plan for Medicare post acute and long term care reform will benefit state lawmakers as they struggle with fiscal crisis.
- The reform effort creates a sustainable, patient-centered long term and post acute care system that will provide Americans more control over their futures, and help ensure state lawmakers endure far less year to year volatility in terms of eldercare budgeting.
Kissito Alerts April 28
April 28, 2009 by admin
Filed under Healthcare Alerts
Source: Health Care Finance News
Title: Swine flu epidemic may boost rapid testing industry
Date: 4/28/09
URL: www.healthcarefinancenews.com/news/swine-flu-epidemic-may-boost-rapid-testing-industry
- For several years Kalorama Information has tracked the successes and failures of ‘rapid’ or point-of-care tests for viruses, including the small but growing rapid influenza test market.
- Kalorama’s publisher says the current attention being given to the swine flu could be an opportunity for test makers to demonstrate the need for rapid testing materials.
- Physicians will want to determine if patients have the common flu or some other virus.
Source: Health Care Finance News
Title: Two national initiatives aim to improve service for physicians and hospitals
Date: 4/28/09
- Cigna’s cost-of-care estimator and extended weekend and holiday call service hours are now available to almost all 550,000 Cigna-contracted physicians, hospitals and free-standing clinics.
- According to a Cigna survey of those who used the health plans cost of care estimator, 80% said receiving the estimate is helpful, 74% said knowing their obligation while in the care setting makes it more likely they will pay the bill, and 72% said the estimate helps them understand their benefits.
Source: Health Care Finance News
Title: Medicaid physician fees grew 15% from 2003 to 2008
Date: 4/28/09
URL: www.healthcarefinancenews.com/news/medicaid-physician-fees-grew-from-fifteen-percent-from-2003-2008
- Between 2003 and 2008, Medicaid physician fees tose 15.1%, closing a portion of the gap with medicare physician payment rates, according to a study by researchers from the Urban Institute.
Source: IFA News
Title: Baucus target july to introduce health reform legislation
Date: 4/28/09
URL: www.ifawebnews.com/articles/2009/04/28/news/health/doc49f5d2ce66731872182144.txt
- Senator Max Baucus is targeting July as a deadline to introduce legislation to improve the nation’s health system.
- The Senator has said that his three goals for any legislation are to lower costs to improve quality and ensure that every montanan has quality, affordable, health care.
Source: McKnights
Title: Long term care groups watching, waiting as government responds to swine flu crisis
Date: 4/28/09
- Swine flu has not, so far, affected residents or employees of nursing homes but the long term care community is staying abrest of the latest developments and information regarding the potentially deadly virus.
- It is recommended that if facilities haven’t already done so, they need to designate somebody to keep up on that.
- The CDC has issued guidance for both health care workers and the public at large concerning the best ways to prevent the swine flu.
Source: Rural Assistance Center
Title: CMS releases medicare billing publication for rural physicians
Date: 4/27/09
URL: www.raconline.org/news/news_details.php?news_id=11020
- A new publication released by CMS offers quick-reference and detailed billing charts, with informaiton for Rural Health Clinics, Federally Qualified Health Centers, SNFs, Home Health Agencies, Critical Access Hospitals, and swing beds.
- The Quick Reference Rural Billing Charts provide basic quick reference rural bulling information for each provider type regarding ambulance services, office visits, hospital services, radiology and diagnostics, clinical lab tests, supplies and drugs, and preventive services.
- The detailed rural billing charts provide comprehensive rural billing information and CMS manual references for each provider type.
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