CMS announced in December that the amendment requiring the development of the HRIII RUG has been repealed. Therefore, as of October 1, 2010 the RUG IV will remain in effect through out the 2010-2011 fiscal year. Facilities will not need to monitor for possible payback or the reconciliation of revenue received since October 1, 2010 under RUG IV. (more…)
Even though both the House of Representatives and the Senate have not yet completed work on their respective bills to restructure the health care delivery system, it seems very likely that we will be experiencing the most significant health care reform legislation since the advent of Medicare and Medicaid. As has been noted by so many key figures in this national debate, the current system is unsustainable, impacting one-sixth of our economy, and if the status quo were to prevail, President Obama’s economic recovery strategy would itself be in “immediate jeopardy.” So while the House leadership and members of the “Blue Dog Coalition” of fiscally conservative Democrats have succeeded in delaying the necessary committee work and a vote on any of the most likely bills being crafted in the near future, in all likelihood some significant health care reform legislation will be enacted, probably by the end of the year. (more…)
Larry Blitz, Manager
It is very evident that most of our health care dollars have been directed toward acute health care. Beginning with the first health care system at Johns Hopkins over 140 years ago, community acceptable standards have been well established and reimbursement strategies have largely paid for these acute services. The creation of Medicare and Medicaid in the 1960’s focused a minimal reimbursement system for elderly patients through these programs.
The story is vastly different for those needed services that follow the acute stay (post acute). Our country by default has accepted a post acute system that is based on the reality of “spending as little as we can for it not to be a problem.” Some health systems in the past have invested minimal sums of resources in order to examine this issue. Other healthcare systems have even entered into the post acute market place in an attempt to provide more of a continuum of care for patients. (more…)
