NIC Notes

Insights in Seniors Housing & Care

Economic Trends  |  Regulatory Environment  |  Senior Housing  |  Skilled Nursing  |  Workforce

Do New Bundles Leave Post-Acute Care Out of the Driver's Seat?

By: Liz Liberman  |  February 07, 2018

The Centers for Medicare & Medicaid Services (CMS) recently announced a new, voluntary bundled payment program, designed to curb Medicare costs for 32 different medical episodes by paying providers a single payment per episode. The new program puts hospitals and physicians in the driver’s seat, enabling them to select or convene care delivery partners and distribute financial benefits earned as a result of reducing the costs to Medicare. The new model, Bundled Payments for Care Improvement Advanced (BPCI Advanced), will replace existing voluntary BPCI models, including BCPI 3, which put skilled nursing providers in charge of care episodes. BPCI Advanced includes several incentives for participation among hospitals and physician groups, but not without drawbacks. If BPCI Advanced gains traction, skilled nursing providers may have to adapt to benefit from the model or risk being left out.

Economic Trends  |  Regulatory Environment  |  Skilled Nursing

2017: The Year of Deregulation for the Skilled Nursing Industry

By: Liz Liberman  |  January 10, 2018

On Christmas Eve, the New York Times published an article describing measures the Centers for Medicare and Medicaid (CMS) took during 2017 to reduce fines levied against skilled nursing properties. The skilled nursing industry may view this change as a welcome respite from real or perceived government over-regulation, especially in an era of downward pressure on occupancy and constrained budgets. Nursing home resident advocates, on the other hand, may view this move as an affront to resident safety. Deregulation remains a top priority for President Trump, and therefore efforts to reduce penalties for nursing homes should not come as a surprise.

Market Trends  |  Regulatory Environment  |  Skilled Nursing

NIH-Funded Study Raises Questions about Accuracy of Five-Star Quality Ratings

By: Liz Liberman  |  January 04, 2018

A recent study conducted with financial support from the National Institute for Health Care Management, part of the National Institutes of Health (NIH), and published in the journal Production and Operations Management found that California nursing homes may be artificially inflating their self-reported data to the Centers for Medicare and Medicaid (CMS) for the five-star rating system on Nursing Home Compare, a website used by consumers, payors, and others to evaluate nursing homes. The five-star rating, discussed at length in a previous NIC blog post, is comprised of a health inspection, staffing levels, and quality metrics. The authors of the study argue that many California nursing homes inflate their self-reported quality metrics, which measure the quality of care patients and residents receive in skilled nursing properties. Their analysis considers the financial incentives that drive such false reporting, providing one of the first analyses of how five-star scores impact profitability. The study demonstrates the need for operators and investors to consider multiple data sources and follow quality metrics closely.