INSIGHTS

On April 29, 2022, CMS released its Medicare Advantage and Part D final rule: Medicare Program; Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs [CMS-4192-F]. Medicare-Medicaid integration is...

Date of Publication: March 7, 2022 The President announced in the State of the Union actions to heighten nursing facility standards, with a focus on Wall Street investment. The White House released a Fact Sheet on February 28, 2022 that details actions to be taken....

Authors: Allison Rizer, ATI Advisory  Date of Publication: February 16, 2022 The Senate Special Committee on Aging held a Hearing on Medicare-Medicaid integration last week, sponsored by Senators Casey (D., PA) and Scott (R., SC). As a health policy professional who...

Author: Allison Rizer For more than a decade, we’ve watched the Financial Alignment Initiative (FAI) evolve from a proposal in the Affordable Care Act to a set of programs operating in nearly a dozen states. FAI offered the promise of integration across Medicare and...

Authors: Laura Benzing, Brie Ensslin Janoski, Arielle Mir, Amy AbdnorImagine being at the doctor’s office when you’re asked for your insurance card. You begin rummaging through your wallet and remember you have multiple insurance cards, one from Medicare, one from...

Authors: Brie Ensslin Janoski, Amy Abdnor, and Arielle Mir  Enacted in March 2021, the American Rescue Plan Act (ARPA) is expected to infuse upwards of $11 billion in additional federal spending to states to bolster Home and Community Based Services (HCBS) in Medicaid...

Authors: Elexa Rallos and Tyler Overstreet Cromer On August 26, the Supreme Court struck down the administration’s temporary moratorium on evictions in communities with high levels of COVID-19 infections. This moratorium suspended evictions in over 90 percent of...

Authors: Allison Rizer, Amy Abdnor, Arielle MirIf you had to choose between living at home or in a nursing facility, which would you choose if you had a disability or were too frail to care for yourself? Most would likely choose their home, but they need support to do...

ATI Contributor: Allison Rizer  Imagine eating at a restaurant and having to choose from more than 100 different salads on the menu. Slightly different ingredients, different sizes, different prices. Maybe some have the same ingredients but with different names....

ATI Contributor: Rebecca Dittrich On the day I became eligible to receive the COVID-19 vaccine, I sat down at my computer at 7:58 AM, ready to grab one of the many appointments I was naively optimistic would become available at 8:00 when my vaccine group opened up. I...

ATI Contributor: Rebecca Dittrich Since news of a coronavirus outbreak at a Washington nursing facility first broke in February 2020, nursing facilities have held the COVID-19 pandemic spotlight. A Google search for “nursing home and COVID-19” returns over 30 million...

While traditional insurance companies sponsor most Medicare Advantage (MA) plans, a growing number of long-term care (LTC) providers—nursing and assisted living facilities—are forming health plans, using special needs plan (SNP) authority under the MA program to focus...

Social need is (rightfully) a growing focus among healthcare policy makers – with recognition that social determinants have considerable impact on one’s health and well-being. There’s a high prevalence of social need among Medicare beneficiaries, with nearly a fifth...

The 2019 Novel Coronavirus (COVID-19) is disproportionately impacting Medicare beneficiaries also eligible for Medicaid (“dual eligible”). This is partially due to a combination of socioeconomic, racial, workplace, and clinical characteristics that align with other...

Beginning in January 2021, the Centers for Medicare & Medicaid Services (CMS) is adding a hospice component to the Medicare Advantage Value Based Insurance Design (VBID) Model. Despite calls to delay the start of the hospice component in VBID, CMS is moving ahead,...

ATI Contributor: Allison Rizer  The COVID-19 public health emergency continues to accentuate racially- and income-based healthcare disparities in our country. And individuals dually eligible for Medicare and Medicaid (“dual eligibles”) are at the center of it all....

ATI Contributor: Allison Rizer  Telehealth has been essential during COVID-19 to preserve access to care, mitigate social isolation risks, and meet the needs of individuals temporarily holed up in their homes. The provision of telehealth advanced about 10 years over...

ATI Contributor: Allison Rizer  Most of us agree: there is value in Medicare-Medicaid integration. But how well do you understand the programs that aim to accomplish integration? I presented on this topic to a group of providers recently and someone bravely mentioned...

ATI Contributor: Allison Rizer  In eight short months, Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) will be operating under new Bipartisan Budget Act (BBA 2018) rules that require D-SNPs to assume a more active role in integrating Medicare and...

ATI Contributor: Tyler Overstreet Cromer  In distributing $100 billion, the Centers for Medicare & Medicaid Services (CMS) must accurately aim funding at providers with the highest COVID-19-related costs while getting cash onto the front lines of healthcare as...

ATI Contributor: Allison Rizer Last year marked one of the most significant policy changes in the Medicare program in a very long time. In 2019, Medicare suddenly became more than the acute/post-acute, medical program it has been for more than five decades, by...

The COVID-19 pandemic will impose unprecedented stresses on our Nation’s hospitals, whose capacity falls well short of the projected demand for beds. As one option to expand capacity, public health officials should consider the possible contribution of post-acute...

ATI Contributor: Allison Rizer Expanding access to telehealth is a top strategy to prevent avoidable hospitalizations and increase the capacity of our health system during the current crisis we are experiencing. This is particularly important for the frail elderly...

ATI Contributors: Tyler Cromer and Elexa Rallos Medicare Advantage plans can now offer a wide range of diverse benefits to address the needs of the aging population, through newly expanded supplemental benefits. This expansion gives plans more flexibility to meet...

Few would expect nursing homes and assisted living operators to be able or willing to manage health care risk for some of the highest-cost Medicare beneficiaries. Yet, earlier this month, Senior Housing News announced the formation of the Perennial Consortium, a group...

For frail older adults, an inpatient hospital stay can be destabilizing, often marking the beginning of a decline in functioning. For these folks and their families, the post-hospital period is a risky, confusing, and stressful time. Our Medicare system offers...

In February 2018, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act (CCA) was passed by Congress and signed by President Trump, making significant policy changes to advance the goals of integrated, person-centered care for...

Our chances are 50/50 that in our old age, we’ll need someone else’s help with basic activities of daily life—like bathing, dressing, eating, getting out of bed. Many families are caught off guard when it happens. Medicare doesn’t cover the long-term,...

ATI founder, Anne Tumlinson, testifies to on the Federal Commission on Long Term Care's recommended changes to U.S. long-term care financing and delivery system. http://www.c-span.org/video/standalone/?c4506129/anne-tumlinson