About Continuum of Care
Post-acute care — often provided at inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities, and at patients’ homes — is vital to the health care delivery system. These providers deliver essential medical and rehabilitative services following hospital care. Hospital case managers help support, and connect patients, families, and caregivers through communication and coordination with post-acute care providers and home and community-based services. This includes the development of a discharge or transition plan that addresses the patient’s goals, needs and treatment preferences, and prepares patients and caregivers for post-discharge care.
Summaries: FFY 2025 Hospice, Inpatient Rehabilitation Facility, Skilled-Nursing Facility Medicare Payment Rules
What’s happening: Summaries of the hospice wage index, inpatient rehabilitation facility (IRF) prospective payment system (PPS), and skilled-nursing facility (SNF) PPS proposed rules are now available.
What else to know: Comments on the proposed rules are due by May 28.
CMS Proposes 2.6% Inpatient Prospective Payment System Rate Increase for FY 2025
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has proposed a net increase to base Medicare inpatient payment rates (market basket update) of 2.6% for fiscal year (FY) 2025.
What else to know: The increase is included in the FY 2025 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system proposed rule. Comments on the proposed rule are due to CMS by June 10.
DMHC Provides Overview of Complaint and Appeals Process
What’s happening: A recording of the March 26 Department of Managed Health Care (DMHC) Complaint and Appeals Process Webinar is now available.
What else to know: This complimentary, members-only webinar includes information about DMHC’s role in the independent medical review and complaint process. DMHC staff provided an overview of their jurisdiction and the consumer and provider complaint processes.
CMS Issues Post-Acute Care Payment Proposed Rules
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its proposed payment policies for inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and hospices for federal fiscal year (FFY) 2025.
What else to know: Comments on the proposed rules are due to CMS by 2 p.m. (PT) on May 28.
CMS Issues FFY 2025 Inpatient Psychiatric Facility PPS Proposed Rule
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its federal fiscal year (FFY) 2025 inpatient psychiatric facility (IPF) prospective payment system (PPS) proposed rule.
What else to know: Comments are due to CMS by 2 p.m. (PT) on May 28.
CY 2025 Medicare Advantage, Part D Payment Changes Finalized
What’s happening: The Centers for Medicare & Medicaid Services (CMS) finalized changes to Medicare Advantage (MA) Part C and Part D payments for calendar year (CY) 2025.
What else to know: Comments on the MA data request for information are due by May 29. The policies are effective Jan. 1, 2025.
CMS Revises Informed Consent Guidance for Hospitals
What’s happening: The Centers for Medicare & Medicaid Services (CMS) updated its Hospital Interpretive Guidelines for Informed Consent.
What else to know: The guidance clarifies the need to obtain informed consent from patients to perform important surgical tasks, and sensitive or invasive procedures, as well as examinations outside of the medically necessary procedure.
CHA to Host DMHC Complaint and Appeals Process Webinar
This post has been archived and contains information that may be out of date.
What’s happening: CHA is hosting the Department of Managed Health Care (DMHC) Complaint and Appeals Process Webinar on March 26 at 9 a.m. (PT).
What else to know: This complimentary, members-only webinar will help attendees better understand DMHC’s role in the independent medical review and complaint process. Registration is open.
CHA Participates in DHCS Population Health Management Summit
What’s happening: CHA recently participated in the Population Health Management Transitional Care Services Summit hosted by the Department of Health Care Services.
What else to know: The summit provided an opportunity for Medi-Cal Managed Care leaders to provide updates on the implementation of transitional care services and share best practices. Several panels included representatives from CHA member hospitals, including Watsonville Community Hospital, Dignity Health, and the University of California, San Francisco.
Recording of IRF Review Choice Demonstration Webinar Available
What’s happening: In August 2023, the Centers for Medicare & Medicaid Services (CMS) initiated the Inpatient Rehabilitation Facility Review Choice Demonstration (IRF RCD) Program in Alabama. CMS plans to expand the program to several other states, including California.
What else to know: On Feb. 13, CHA hosted a webinar on the IRF RCD; a recording is now available.