Harvard Pilgrim reports strong Q2, despite CEO's departure

Harvard Pilgrim Health Care saw a big jump in net income during the second quarter of 2018, which wrapped up weeks after the health plan's CEO abruptly resigned over unspecified behavior. more

8/15/2018

Ohio Medicaid to try out transparent PBM pricing model

Ohio's Medicaid department is directing its managed-care organizations to quit their contracts with pharmacy benefit managers because of opaque pricing practices and strike up new arrangements with transparent vendors. more

8/15/2018

VA accused of failing to pay bills for healthcare company

The owners of a New Hampshire provider stopped caring for 16 veterans as of Friday because they were unable to get about $60,000 in bills paid by the Veterans Affairs Department. more

8/15/2018

Providence Health sued over alleged $188 million Medicare upcoding scheme

Providence Health and Services has been sued by a data analysis firm that claimed the 50-hospital system pushed its doctors to add complications or comorbidities to treatment documents so they could get higher Medicare reimbursement. more

8/15/2018

Few hospitals dedicate space for family caregivers, but that could change

Montefiore's Burke Rehabilitation Hospital opened what it says is the nation's first family-caregiver resource center in a rehab hospital. They're also rare in acute-care hospitals, but efforts to reduce readmissions could convince hospitals to add... more

8/15/2018

Young nurses seek advanced degrees, leaving gaps in direct patient care

More young nurses are opting to get advanced degrees, which could help fill gaps in primary care. But it could also take them away from patients' bedsides, according to a new survey. more

8/15/2018

Hospital group loses bid to toss out accusations that it siphoned $1 million-plus from nursing home to fund other parts of system

A New York hospital system has whiffed on its attempt to bury a whistleblower's claims that it funneled dollars away from its nursing home to pay other parts of the organization. more

8/15/2018

Providers go back to college to find success solving the nursing pipeline problem

In talking to young students and potential future workers for their communities, leaders at one Minnesota-based eldercare provider noticed that references and knowledge typically were hospital-oriented. more

8/15/2018

Judge scolds prosecutors in Esformes record $1 billion fraud case, tosses key evidence

Federal prosecutors — aiming to take down the alleged perpetrator of one of the largest Medicare fraud schemes in history — may have been dealt a blow on Friday. more

8/15/2018

Advocates sue to block Arkansas' Medicaid work requirement

Advocacy groups sued to block Arkansas' Medicaid work requirement in federal court, two months after they won a federal ruling halting Kentucky's similar waiver program. more

8/14/2018

Trump's immigrant healthcare rule could hurt low-income populations

The Trump administration reportedly is nearing completion of a new immigration rule that healthcare providers and plans fear will harm public health and their ability to serve millions of low-income children and families. more

8/14/2018

Oscar Health to launch Medicare Advantage plans in 2020 with Alphabet investment

A $375 million investment from Google's parent company, Alphabet, will help Oscar Health launch Medicare Advantage plans and deepen its presence in the individual and small-business markets. more

8/14/2018

Healthix drops IBM, turns to Verato for patient matching

The country's largest public health information exchange will use Verato's Universal MPI for referential patient matching, which it says will reduce uncertainty when linking patients to their health data. more

8/14/2018

Nursing home star ratings haven't brought reduction in preventable hospitalizations, study finds

Nursing homes' publicly reported star ratings have increased substantially since the adoption of the Five-Star Quality Rating System. But there hasn't been a corresponding drop in preventable hospitalizations, according to a new study, and "teaching to the test" could possibly be a culprit. more

8/14/2018

Woman may serve 10 years after defrauding program designed to keep patients out of nursing homes

An Illinois woman pled guilty last week to charges that she perpetrated a healthcare fraud scheme designed to keep patients out of nursing homes. more

8/14/2018

Shattering my rose-colored glasses: From provider to family member

Over time and with specialization your work focus can become narrowed. You can even convince yourself that healthcare has progressed to the point of thinking we are doing a remarkable job. But being on the other side with my father has taught me how far we have to go. more

8/13/2018

Top industry association 'disappointed' after IRS leaves skilled care in the cold

The nation's largest skilled nursing trade group expressed "disappointment" Friday that for-profit skilled nursing facilities won't benefit from the Trump administration's new tax law. more

8/13/2018

It's not about you. It's about your age.

We often hear that ageism is one of the barriers facing long-term care residents these days. Turns out it's a barrier many employees may be up against as well. more

8/13/2018

Extendicare to pilot 'smart' senior home; gives update on CEO switch

One of the largest providers of skilled nursing care in Canada is testing out a new "smart" senior home model in assisted living, which it may also try out in the skilled nursing space. more

8/13/2018

QAPI spells success for SNFs

Outdated operating models - solely meeting the basic needs of patients - does not bode well for SNF operators to survive. more

8/10/2018

CMS proposes Medicare ACO overhaul to prod more risk-taking

"Pathways to Success" is predicted to save the Medicare program $2.2 billion over 10 years. more

8/10/2018

Analysis explores the secret sauce for successful hospital-SNF collaboration

Hospitals are working much more closely with skilled nursing facilities, aiming to form bonds and avoid costly and harmful hospital readmissions. But little is understood about how they're creating these linkages. more

8/10/2018

Sabra expects skilled care occupancy rebound in 2019, though mom and pops may face some struggles

While occupancy of its skilled nursing properties might not be quite up to snuff, a CEO of one of the field's top operators says we may be reaching bottom, with a much brighter 2019 on tap. more

8/10/2018

CVS blames 'deteriorating' skilled care sector for poor Omnicare performance, $2.6 billion quarterly loss

Pharmacy giant CVS Health posted a $2.56 billion loss for the most recent quarter and is blaming its lagging fortunes partly on the "deteriorating financial health of numerous skilled nursing facility customers." more

8/9/2018

Genesis touts 'strong' second quarter as CEO says skilled care admissions may be reaching bottom, ripe for rebound

The largest player in the skilled nursing space touted "strong" second quarter financial results, with leaders also expressing optimism that census declines might finally be hitting bottom. more

8/9/2018

Providers likely asking the wrong questions to screen for Alzheimer's, new study reveals

Providers can improve screening questions to more accurately detect patients who may be at risk for developing Alzheimer's disease and other aging-related problems, according to a new study published in the journal The Gerontologist. more

8/9/2018

... and now back to that little ol' entity called HCR ManorCare

While so much talk has been about ProMedica's daring venture into long-term care, it seems a lot has been overlooked about the former No. 1 nursing home chain in the country that it has partnered with. more

8/8/2018

CNA program retains talent at 'record level' for one nursing home

In a challenging labor market, one Missouri nursing home is bucking the trends, and retaining young local talent at a "record level." more

8/8/2018

New 'Hospital in the Nursing Home' program helps keep elderly out of the ED

A new collaborative program between nursing homes and a local hospital in Australia is keeping the elderly out of the emergency department, and rapidly decreasing hospital readmissions. more

8/8/2018

Higher acuity, assisted living behind nursing home Medicare spending growth, experts say

Increased acuity and investment in dual eligibles at the state level have resulted in long-stay nursing home residents driving Medicare spending growth, according to a new analysis published this week in Health Affairs. more

8/8/2018