Coordinating post-acute services for patients has been an ongoing challenge during the COVID-19 pandemic. One solution is for hospitals to form partnerships with local skilled nursing facilities. These partnerships can help hospitals find adequate care for complex patients. Hospital case managers and other staff can help the skilled nursing facility with difficult problem-solving and care coordination.
A False Claims Act lawsuit involving alleged kickbacks for placing drugs on formularies has been settled for $12.5 million. The case is instructive because it shows the False Claims Act can apply even when the government has not lost money from the alleged violations.
A healthcare organization’s Medicare Bundled Payments for Care Improvement Advanced (BCPI Advanced) program resulted in lower hospital readmission rates. The program reduced readmission rates from 30% to 19%.
In April, CMS unveiled “Hospitals Without Walls,” a COVID-19 pandemic-specific policy likely to affect both hospitals and surgery centers. It provides a path for a Medicare-approved ASC to change its status to a hospital, thus allowing just about any Medicare-approved procedure permitted in a hospital to be performed in a surgery center — and at hospital reimbursement rates.