Posts tagged "CMS"

The Illinois Medicare-Medicaid Alignment Initiative is Coming Soon

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In Illinois on January 1, 2014, those individuals who are beneficiaries of both the Medicare and Medicaid programs may begin to enroll in a redesigned health care delivery system. These new managed care plans will hopefully be easier to navigate, reduce inefficiencies, save costs and deliver improved health outcomes for this population. Learn more by... Read more »

Obamacare and the Evolution of Medicare and Medicaid

A flurry of activity, envisioned by Obamacare (ACA) and driven by fiscal necessity, is beginning to transform how providers of long term services and supports (LTSS) address the needs of older adults. Despite the growing interest in how the ACA will change healthcare delivery for working Americans, there is not much public coverage on the changes, which... Read more »

Quality Care for the Older Adult Living at Home in Illinois - Part II

At the conclusion of my last blog post I posed the question that since State Medicaid programs are currently deficient in assuring compliance with quality standards in the delivery of HCBS in ALF settings, is it reasonable to assume that MCOs will be better suited to not only that task, but also with regards to... Read more »
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Quality Care for the Older Adult Living at Home in Illinois - Part I

As the Illinois Department of Healthcare and Family Services (HFS) continues at full gallop to enroll older adult Medicaid beneficiaries into managed care organizations (MCOs) during Q1 of 2013, many remain skeptical at how home and community based services (HCBS) programs will be measured and monitored and whether incentives will be aligned to meet desired goals. HCBS... Read more »

Chronic Conditions No Longer Barrier to Medicare Services

On October 16, the US Department of Health and Human Services and disability rights attorneys entered into a proposed settlement of a class-action lawsuit (Jimmo v. Sebelius), that if approved by the Court will clarify the so-called “improvement standard” used in the past by Medicare providers (i.e. skilled nursing homes (SNFs), home health providers, or other... Read more »

Medicaid Services Expand in California

A couple of weeks ago, exciting news from California created buzz among Illinois providers of community based care for older adults and people with physical disabilities. On September 4, California’s Health and Human Services Agency announced (here) that it is the first state to obtain regulatory approval for implementing the Community First Choice (CFC) option, a new federally funded... Read more »
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Medicare Commission Raises Questions about Care Coordination

Before I comment on the latest MedPAC report…. Thursday’s big news from the Supreme Court continues to elicit commentary from health care, legal and political analysts. For what it’s worth, I found Justice Robert’s opinion to be in perfect harmony with what I learned in law school: if the Supreme Court can find a way... Read more »

Affordable Care Act and the Medicaid Long Term Care Dilemma

As we wait (patiently) to learn whether the Supreme Court will uphold or strike down the Affordable Care Act (ACA), in part or in its entirety, let’s ponder the fate of Medicaid as the funder for long term services and supports (LTSS). After all, the survival of the ACA will mean an dramatic expansion of the... Read more »

Measuring Post-Acute Care in LTCHs, IRFs, SNFs and HHAs

Huh? What’s up with all the acronyms? Great question and truthfully besides taking up less space in the blog’s headline, the acronyms listed are settings for post-acute care (i.e. post-hospital care) and (not surprisingly) each has its own quality and outcome measurements as well as reimbursement systems. (Check the blog’s glossary for more information about... Read more »
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    Bruce Lederman

    Bruce Lederman has over 25 years experience in the senior care field as a direct care provider and thought leader. Bruce was CEO and president of his own firm that operated skilled nursing facilities in Illinois. He is a former nursing home administrator and has consulted to numerous elder care providers on planning for strategic growth as well as process improvement. Recently he served as board chair of CJE SeniorLife, a leading non-profit elder care provider in the Chicago area. Bruce is currently employed as chief strategy officer for a company providing skilled nursing services in communities throughout Illinois and Missouri.

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