Literature Review

Why not-for-profit health systems need positive margins: Deloitte Becker's Hospital CFO, by Andrew Cass; 2/28/24Health system margins are the "lifeblood of a healthy, patient-centered, innovative health care system and community," according to a report from consulting firm Deloitte.  "Claims that profits are not important in fact undermine the ability to fund the mission, serve the community, and deliver better, equitable care," Deloitte said in the report. ... "[Systems] should consider a holistic approach that integrates margin drivers to create a balanced transformation portfolio, according to the report. Timing and sequencing are important within each driver and "a full understanding of the dollar impact and priority of each is necessary for margin improvement to be successful."

How AI will help the world's top hospital CEOs transform health careNewsweek, by Jeff Young; on 2/28/24Artificial intelligence is quickly showing the potential to revolutionize many aspects of care giving, from cancer diagnoses to clerical work. But AI also presents new risks, uncertainties and vexing ethical questions. With the release of Newsweek's ranking of the "World's Best Hospitals," executives at leading hospitals around the world told us how they are using the power of AI.

The best changes 32 healthcare leaders made this year Becker's Payer Issues, by Rylee Wilson; 2/27/24Question: What is one change you made in the last two years that had great results?Leaders in the payer space are making changes to simplify members' experiences, improve equity and level-up the way their teams work together. The 32 leaders featured in this article, part of an ongoing series, [answered this question].

Chapters Health System CEO on prioritizing value-based care initiatives in the home Home Health Care News, by Andrew Donlan; 2/26/24Andrew Molosky, the president and CEO of Chapters Health System, is keenly aware of the struggles that coincide with turning a large health care provider organization into a value-based one. The first priority in that situation, in his mind, is making sure that the entire organization is on the same page in terms of what value-based care really means, he told Home Health Care News ... “You want to get to the point where you can manage populations in the home,” Molosky said. “That becomes a parlay to reducing ER spend in a full-risk environment. It becomes earlier intervention for a hospice or home health episode. 

C-suites, clinicians are burning out at both endsBecker's Hospital Review, by Alexis Kayser; 2/22/24C-suite leaders and clinicians often feel they are on opposite sides of an ever-expanding chasm. But they actually have a lot in common, according to Bruce Cummings and Paul DeChant, MD — a former executive and a former practicing physician, respectively, and perhaps an unlikely pair. Executives and physicians are both knowledge workers. Both are trained to spot and solve problems. Both crave the autonomy to fix those problems — but often, neither feels they truly have it. Both are far strides from the bright-eyed, difference-driven graduates they once were. Both are exhausted, and neither really knows how to talk about it. 

New Jersey system gets historic 'A+' credit ratingBecker's Hospital CFO Report, by Alan Condon; 2/19/24Camden, N.J.-based Cooper University Health Care has earned an "A+" credit rating from Fitch Ratings after receiving two credit upgrades from S&P Global and Moody's since 2022. ... "Fitch's rating is another indicator that our focus on becoming an exceptional academic health system by managing our finances in a way that allows us to continue to grow to meet increasing demand from patients seeking the higher level of care our experts provide is the correct strategy," Cooper co-CEO Anthony Mazzarelli said.Editor's Note: Cooper University's Hospice and Palliative Medicine (HPM) Fellowship is an important component of their academic health system.

The bottom line: Top billing, financial mistakes responsible for home health agency struggles

Reduced federal share may force state Medicaid programs to cut services, HCBS expert saysMcKnights Home Care, by Adam Healy; 2/15/24The Congressional Budget Office this month released its “Budget and Economic Outlook” report for the coming decade. In its report, CBO predicted a roughly $58 billion drop in federal Medicaid outlays for 2024 compared to 2023 — a 9% decrease in federal Medicaid spending, due in part to fewer beneficiaries on states’ Medicaid rolls. Reduced Medicaid outlays ... has placed an even greater strain on states to pay for these Medicaid programs, according to Damon Terzaghi, director of Medicaid HCBS for the National Association for Home Care & Hospice.

CMS issues additional guidance on program to allow people with Medicare to pay out-of-pocket prescription drug costs in monthly paymentsCMS.gov; 2/15/24The Inflation Reduction Act’s Medicare Prescription Payment Plan will allow people to pay Medicare Part D out-of-pocket costs over the course of the year starting in 2025. [On February 15th,] the Centers for Medicare & Medicaid Services (CMS) released the second part of draft guidance for the Medicare Prescription Payment Plan that outlines requirements for Medicare Part D plan sponsors, including outreach and education requirements, pharmacy processes, and operational considerations, for the program’s first year, 2025. 

Gentiva engineers unique palliative care payment system via AIM programHospice News, by Jim Parker; 2/12/24Gentiva Health Services has committed to expanding its recently established Advanced Illness Management (AIM) palliative care model in 2024, including its unique approach to reimbursement.

How New Day Healthcare plans to be the face of a changing home health landscapeHome Health Care News; 2/12/24New Day Healthcare has been one of the most active acquirers in home health care over the last year. As it grows, it’s looking to set itself apart from the home health company archetype of yesteryear.

Senior living providers can tap into $25 million grant to develop dementia-specific respite servicesMcKnights Senior Living, by Kimberly Bonvissuto; 2/7/24Senior living operators who provide, or are considering providing, respite services for family caregivers of people living with dementia can apply for a piece of $20 million in grant funding. The Alzheimer’s Association will use a $25 million, five-year grant award from the US Department of Health and Human Services’ Administration for Community Living to establish a new Center for Dementia Respite Innovation tasked with making respite services and service providers more dementia-capable. 

Review choice demonstration is here to stayHome Health Care News, by Patrick Filbin; 2/1/24The Centers for Medicare & Medicaid Services (CMS) has been tight-lipped about its Review Choice Demonstration (RCD) plans beyond May 2024. However, industry leaders believe RCD will be extended across the country on a more permanent basis — a development that agency leaders should recognize as a momentum shifting change. “We’re seeing a monumental shift in home health care and how we actually operate,” Kim Gaffey, founder and CEO of Gaffey Home Nursing and Hospice, said during a webinar Thursday.