/ en Thu, 01 May 2025 20:18:33 -0500 Fri, 29 Dec 23 11:44:18 -0600 /white-papers/2023-12-29-white-paper-medicares-ltch-outlier-policy-needs-reforms-protect-extremely-ill-beneficiaries <div class="container"><div class="row"><div class="col-md-8"><h2><span>Executive Summary</span></h2><p>Long-term care hospitals (LTCHs) play an important role for Medicare beneficiaries by caring for complex patients who require extended hospitalization. Traditional Medicare reimburses for this care through the LTCH prospective payment system (PPS). This PPS includes a high-cost outlier (HCO) policy that, as with similar policies in other payment systems, is intended to ensure that LTCHs are adequately reimbursed for extremely costly care provided to the most severely ill beneficiaries. It specifically does this by helping ameliorate some of the extraordinary costs LTCHs experience when caring for these beneficiaries.</p><p>Congress, beginning in 2016, put in place a dual-rate payment system under the LTCH PPS. This fundamental change in the payment system and other coinciding market factors dramatically reshaped the landscape of both LTCHs and the beneficiaries they serve. The HCO policy and underlying methodologies, however, remained largely unchanged. The result is an HCO policy that is now failing to achieve its stated purpose. Specifically, as the fixed-loss amount for HCO cases continues to rise, LTCHs are incurring greater and greater losses. Absent swift action from policymakers, financial pressures on LTCHs will likely result in loss of essential access for some of Medicare鈥檚 most severely ill beneficiaries. This will have ripple effects across the care continuum, placing additional burdens on short-term acute care hospitals and their intensive care units (ICUs), which may no longer be able to partner with LTCHs for the care of this unique population due to financial challenges or closures.</p><p>AHA recommends that policymakers take a number of actions to ensure that LTCHs can continue caring for their beneficiaries and communities. Specifically, AHA suggests several reforms that CMS should make in its annual regulatory cycle to relieve the extreme pressures on LTCHs caused by the HCO policy, including:</p><ul><li> Indexing the fixed-loss amount to market basket growth, which would help ensure the fixed-loss amount grows consistent with payment;</li><li>Including all LTCH cases in its methodology when calculating annual updates to the fixed-loss amount, which would provide more stability from year to year as well as provide only one fixed-loss amount for the entire LTCH PPS, allowing providers to better predict both HCO losses and the partial relief provided under the system; and</li><li>Initiating an analysis of LTCH cases鈥� cost variation within payment groups to determine whether refinements to improve overall payment accuracy are needed.</li></ul><p>AHA also recommends that Congress make fundamental reforms to the LTCH payment system, including:</p><ul><li>Increasing funding for HCO cases;</li><li>Indexing future changes to the fixed-loss amount to inflation; and</li><li>Adopting a stop-gap policy, pending a further restructuring of the LTCH PPS. Background</li></ul><p>View the detailed white paper below.</p></div><div class="col-md-4"><a href="/system/files/media/file/2023/12/white-paper-medicares-ltch-outlier-policy-needs-reforms-to-protect-extremely-ill-beneficiaries.pdf" target="_blank" title="Click here to download the White Paper: Medicare鈥檚 LTCH Outlier Policy Needs Reforms to Protect Extremely Ill Beneficiaries"><img src="/sites/default/files/2023-12/cover-white-paper-medicares-ltch-outlier-policy-needs-reforms-to-protect-extremely-ill-beneficiaries.png" data-entity-uuid data-entity-type="file" alt="White Paper: Medicare鈥檚 LTCH Outlier Policy Needs Reforms to Protect Extremely Ill Beneficiaries"></a><p> </p></div></div></div> Fri, 29 Dec 2023 11:44:18 -0600 LTC and Rehab /news/headline/2022-06-09-fda-issues-update-heart-device-recall-0 <p>The Food and Drug Administration yesterday released an <a href="https://www.fda.gov/medical-devices/medical-device-recalls/medtronic-recalls-hvad-pump-implant-kit-pump-weld-defect?utm_medium=email&utm_source=govdelivery">update</a> on Medtronic鈥檚 recall of 1,614 devices used to pump blood from the heart to the rest of the body because the devices may malfunction. The notice updates affected models of the Heartware Ventricular Assist Device System and recommended actions. Medtronic initiated the recall in April due to a pump weld defect.</p> Thu, 09 Jun 2022 15:16:23 -0500 LTC and Rehab /node/681453 <p>This pamphlet is an example of an active DEI initiative at a health organization. They clearly define diversity and inclusion, why it's important, outlining their mission and explaining what they do, and identifying their leaders and members. Most importantly, they indicate how they should be percieved in the community and in the hospital so they may be held accountable.</p> Thu, 06 Jan 2022 15:02:13 -0600 LTC and Rehab /letter/2018-02-07-aha-urges-cms-hhs-convene-expert-panels-post-acute-care-pps-model <p>AHA comments to provide feedback on the work that the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary for Planning and Evaluation (ASPE) are undertaking to develop a unified post-acute care prospective payment system (PAC PPS). AHA's post-acute care membership includes 267 long-term care hospitals (LTCHs), 1,159 inpatient rehabilitation facilities (IRFs), 761 skilled-nursing facilities (SNFs), and 896 hospital-based home health (HH) agencies. The current CMS and ASPE work to build a common payment system for these four settings, as mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014, is of great importance to them and to the AHA.</p> Wed, 07 Feb 2018 13:00:16 -0600 LTC and Rehab /press-releases/2017-01-05-daniel-ari-mendelson-ms-md-facp-agsf-cmd-lead-ahas-section-long-term-care <div class="outlineContent clearfix"><p>The 黑料正能量 Association (AHA) today announced that Dr. Daniel Mendelson will be chair of the AHA鈥檚 Section for Long-Term Care and Rehabilitation Council. He is the associate chief of medicine and director of palliative care for Highland Hospital at the University of Rochester (UR) Medical Center in Rochester, N.Y.</p><p>The council comprises CEOs and senior executives from the nation鈥檚 leading hospitals representing rehabilitation, acute long-term care, skilled nursing, home health and continuing care services. As chair, Dr. Mendelson will lead the section鈥檚 council on public policy issues of concern to post-acute and continuing care providers and AHA member service strategies.</p><p>Mendelson helped establish UR Medicine Geriatrics Group, which provides primary medical care at several nursing homes and assisted living facilities; he has served as the group鈥檚 associate medical director as well as medical director of several nursing homes. He co-founded and continues to co-directs the Geriatric Fracture Center at Highland Hospital and lectures worldwide about topics related to fragility fractures and co-management. He is the founder of the Palliative Care Consultation Service at Highland Hospital and was one of the first certified palliative care physicians in the U.S. Mendelson is the William and Sheila Konar Family Professor of Geriatrics, Palliative Medicine, and Person-Centered Care in the Division of Geriatrics at the UR School of Medicine & Dentistry.</p><p>Mendelson serves or has served as a member of several local, not-for-profit boards of directors, as well as the boards of UR Medicine Home Care, and Lifespan of Rochester, which helps elders take on the challenges of aging successfully. He has also served on the ethics, quality, and nominating committees of the American Geriatrics Society as well as the ethics committee of the NY Chapter of the American College of Physicians. A graduate of Rochester Institute of Technology in chemistry, Dr. Mendelson received his master鈥檚 degree in biophysics and his medical degree from the University of Rochester where he also completed residency in Internal Medicine and Fellowship in Geriatrics.</p><p>Kenneth Bowman, CEO, Van Matre Healthsouth Rehabilitation Hospital, Rockford, Ill., will serve as chair-elect and will assume the role of chair in 2018. Jon Skinner, president, Baylor Institute for Rehabilitation, Dallas, Texas, is the immediate past chair.</p><p>Newly elected members to the governing council include: <strong>Jason Bernd</strong>, vice president, Novant Health Charlotte Orthopedic Hospital, Charlotte, N.C.; <strong>Michelle Gittler</strong>, M.D., medical director, Schwab Rehabilitation Hospital, Chicago; <strong>Cynthia Kelleher</strong>, president and CEO, University of Maryland Rehabilitation & Orthopedic Institute, Baltimore; <strong>Robert Larrison, Jr.</strong>, president, Carolinas Rehabilitation, Charlotte, N.C.; <strong>Mary Moscato</strong>, president, Hebrew Rehabilitation Center, Boston, Mass.; and <strong>Jose Vargas</strong>, M.D., medical director, West Gables Rehabilitation Hospital, Miami.</p><p>The new council members join the following current members: Mary Armstrong, board member, Park City Medical Center, Intermountain Healthcare, Inc., Park City, Utah; Joan Doyle, executive director, Penn Home Care and Hospice Services, Bala Cynwyd, Pa.; W. Lee Gentry, vice president & administrator, Baptist Health Rehabilitation Institute, Baptist Health System, Little Rock, Ark.; Lori Jarboe, CEO, HealthSouth Lakeview Rehabilitation Hospital, Elizabethtown, Ky.; Derrick Jones, CEO, Lovelace Rehabilitation Hospital, Ardent Health System, Albuquerque, N.M.; Yameeka Jones, CEO, Vibra Hospital of San Diego, San Diego; Lee Simpson, CEO, Post Acute Medical Specialty Hospital of Tulsa, Okla.; Gia Smith, CEO, Central Valley Specialty Hospital, Modesto, Calif.; Douglas Struyk, president and CEO, Christian Health Care Center, Wyckoff, N.J.; and Tonja Williams, president and CEO, Continuing Care Hospital, Lexington, Ky.</p><h2>About the Section for Long-Term Care and Rehabilitation</h2><p>AHA鈥檚 Section for Long-Term Care and Rehabilitation supports hospital providers of post-acute services, including rehabilitation, long-term acute, skilled nursing, home health and continuing care services as they build systems of care to improve the health status of their communities. The Section is guided by a council composed of leaders representing some of the country鈥檚 leading hospitals and post-acute care providers. Council members serve as representatives of their member peers as they advise the AHA on member service strategies, public policy issues, advocacy positions and emerging issues, as well as serve as a channel back to the post-acute care field.</p><h2>About the AHA</h2><p>The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at <a href="/">www.aha.org</a>.</p></div> Thu, 05 Jan 2017 00:00:00 -0600 LTC and Rehab