Looking forward to meeting our readers at the Zimmet Conference taking place this week in Mohegan Sun. The topic this year is “Roaring Reimbursement”. You can find more information at the conference site.

WHITE HOUSE:

With DC in the throes of August, everything is moving slower. The White House mostly focused on announcements related to prior initiatives, including $125 million in grants for underserved small businesses through the “Capital Readiness Program”, touting their manufacturing investments and low unemployment rates. One item of indirect interest for us:

• They released a new comprehensive strategy on developing a cyber workforce equipped to navigate the cybersecurity challenges of tomorrow. With yet another health system data breach affecting healthcare providers, the need for investment in a stronger cybersecurity infrastructure has never been more apparent. The full strategy is available here (PDF).

CONGRESS:

With Congress out of town, the focus, as it does every summer, switches to campaigns, posturing and look backs at the earlier part of session. Background work continues on a deal to avert a potential government shutdown on September 30^th with no clear path in sight. It’s going to be a tight legislative month when they come back in September, but as is often the case, a deal will likely only come together at the last moment. Elsewhere in the political world:

• The Congressional Research Service issued a report which provides a generalized overview of AI and the current landscape of regulation governing its usage. It’s a very useful primer in understanding the current federal approach to regulating AI.

• For those of you in Ohio, there is a special election this Tuesday for Issue 1, which affects the ability of voters to amend the state constitution.

• Political fundraising is often used a proxy for electoral enthusiasm and how the public perceives a candidate. To that end, Democrats are concerned about flagging Presidential fundraising.

• A byproduct of the Donald Trump era has been the impact on downstream races, both at the Congressional and state levels. One area that has been particularly hard hit? State GOP parties, which can potentially have significant repercussions in identifying and developing quality candidates.

• California operates under one of the most prolific ballot initiative systems in the country with voter asked to weigh in a wide variety of public measures. An interesting one that impacts advocacy is being floated for next year.

• The White House is pushing to end remote work for federal agencies.

• A look at the big winners and spenders from the return of Congressional earmarks.

• The CRS also released a report outlining the usage of AI in federal election campaigns.

AGENCIES:

CMS issued the final 2024 proposed payment rule for SNF’s. Included in the final rule is a 4% increase (in the aggregate) for all SNF’s. Obviously, each facility is impacted differently (see the z-INTEL tool of the month below), but this reflects a slight increase (of 0.3%) over the proposed rule. The full final rule can be accessed here (PDF).

CMS announced Part D premiums for 2024. You can access the formal announcement here (PDF), which can be found at their central resource page.

CMS announced a new model for individuals with dementia called the “Guiding an Improved Dementia Experience” model. The central resource page is here. The fact sheet is here (PDF) and an FAQ is here. It’s an important program to monitor as there may be opportunities for facilities who provide dementia services.

HHS announced the formation of a new office focused on long Covid.

The OIG at HHS released an audit of the usage of Telehealth for patients with ESRD, finding that while useful, providers collected very little information related to the provision of services. The full report can be accessed here (PDF).

FROM THE NOTEBOOK:

• The Kaiser Family Foundation explored dual-eligibles and the source for their Medicare coverage.

• In a surprise to no one, yet another study showed that foreign born nurses can have a positive impact on person-centered care in SNF’s.

• An interesting op-ed from the Hill on how to change Medicaid to ensure more seniors can access long-term care benefits.

• Senior CMS officials posted a blog at Health Affairs analyzing the ACO model.

• United Health announced the elimination of prior authorization requirements for quite a few procedures.

z-INTEL Tool of the Month: Wage Index Adjustment

Much was made of CMS’ proposed annual payment rule for SNFs that resulted in a net 3.7% Medicare rate increase effective October 1, 2023. It’s important to realize that the 3.7% increase is for all SNF’s in the aggregate, not for each facility. One key factor is the annual change to the wage adjustment index, which will impact every facility differently. At the extremes, operators in Sante Fe, New Mexico are going to wake up on October 1, 2023, with a $150/day Medicare rate increase, while it will be overcast skies in Ithaca, NY as rates begin their decent to a $60/day phased-in cut. z-INTEL has a dynamic PDPM rate modeler here, and provides a detailed two-year trending report for the area wage index for every county in the nation here.

Questions? Email us at support@myzpax.com.

z-INTEL WhatsApp info:

• Group Invite Link: https://chat.whatsapp.com/EoNiPi8ezrOBV6SW1Gf7nD
• Status Link: https://wa.me/message/WMSWZATTB5D6E1