MiraMed Global Services Podcast

There’s recently been a change of plans by the federal government that will positively affect many of America’s hospitals.

Something strange happened in Cleveland late last month.  Joe Biden was giving a speech on the economy when he made the following statement: “You know, if we don’t do something about Alzheimer’s in America, every single solitary hospital bed that exists in America—as the nurses can tell you—every single one will be occupied in the next 15 years with an Alzheimer’s patient—every one.” 

We've all witnessed occasions where someone who's had a tumble, but looks to be unharmed, is nevertheless encouraged to go to the emergency room to have a once-over—just to be sure. Now, however, you'd have to stop and give that some additional thought, because we are seeing increasing signs that payers are beginning to redefine what they deem to be reasonable and payable emergency department (ED) services.

It is sad when relations between fellow humans devolve into strife, leading to hard feelings and demoralization.  While violence rarely erupts in today’s business world, there are still those occasions when owner and employee are at odds.  Sometimes, the employee resentment—whether reasonable or not—can transform into serious action.   In recent days, we have seen such action on the part of employees bubble over in American hospitals.  Let’s look at two notable examples.

The United States Supreme Court may soon serve as the arena for a battle between a couple of organizational heavyweights, with one substantially outweighing the other.   In one corner is the American Hospital Association (AHA).  While strong and influential, it cannot compare to the unmatched might of the federal government, as represented in this legal contest by the U.S. Department of Health and Human Service (HHS) and its new secretary, Xavier Becerra 

Today's article will conclude our look at the massive 2022 IPPS Proposed Rule (PR). So far, we've summarized how the PR treats topics such as payment rates, quality measures, negotiated payment disclosure, residency programs and efforts to reduce hospital readmissions. Based on a summary of the PR released by the Centers for Medicare and Medicaid Services (CMS), we will now provide some of the remaining highlights of the government's proposed changes impacting hospitals in FY 2022.

Today’s article is a continuation of last week’s treatment of Medicare’s 2022 Inpatient Prospective Payment System Proposed Rule (PR), released in late April.  As we pointed out previously, the PR contains over 1,900 pages of proposals.  Consequently, we have found it necessary to break down the proposed changes among multiple alerts so that we might provide as many relevant highlights as possible to our readers.  With that said, the following will act to summarize more details in the PR—beyond what we summarized last week—that hospital executives and clinicians will find most relevant.

Last week, the Centers for Medicare and Medicaid Services (CMS) released its Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Rates Proposed Rule, along with a fact sheet that acts to summarize the critical parts of the proposals. The following will highlight some of the more critical components of the Proposed Rule (PR). As the PR is over 1,900 pages long, our summary will be provided in a multi-part series of alerts.

The HAH model today is seen as beneficial for older patients and those with chronic diseases, such as asthma, congestive heart failure and COPD.  It has the added benefit of alleviating space in hospitals that have otherwise reached capacity.  As the American population continues to age, this model of care will be seen as an increasingly appealing option for both facilities and patients.

In the midst of a declared public health emergency (PHE), it is more important than ever to receive direction from our leaders that is both consistent and supportable.  Vacillation and mixed messages are not a good look.  The question is: are recent announcements concerning the ongoing COVID event creating confusion among the general population and even healthcare workers?