Change Up, Mash Up

 Change Up, Mash Up

 

 

Change Up, Mash Up

Enough about skilled nursing facilities! LTC Contracting’s newest video will focus on the great work substance abuse and addiction treatment centers are doing, although there are some corrupt providers out there taking advantage.

Transcript:

Steve Shain: Hey everyone! We’re back, thank you for joining me again. This time we’re changing things up. We’re not talking about skilled nursing facilities. Enough with the skilled nursing facilities, we don’t want to hear about it anymore! Today we’re talking about substance abuse and addiction treatment centers. These guys are doing such wonderful work, they really are. As I meet with more and more providers, I am so impressed with the dedication that they have and the real interest they have for the rehabilitating of the people that are there and it makes me happy.

(piano music)

Know what I mean? So it makes me happy but at the same time, there are always a couple of bad apples out there. They’re there, there are some unscrupulous ones out there trying to target people that are vulnerable and therefore, if you heard about it, Google AdWords as of January of this year went global in their band on keywords that are related to this industry. So providers that have been looking out to use keywords in order to target potential clients are now unable to do this because of those unscrupulous providers out there. Which is kind of serious.

(piano music)

Know what I mean? So what do we do? We got a lot of good guys, a couple of bad guys, or not bad guys but misdirected, and therefore the industry is having it a little tough. What also is tough is that the insurance companies are still trying to get their hands around this industry because it’s blowing up with the opioid crisis and so much more need in the community for addiction treatment that they were still working with some providers out of network, some in-network and it’s really gotten complicated where their networks are becoming robust. So, we at LTC Contracting are working with the insurers and trying to identify the correct fit for the providers that work for them and at the same time working with providers and making sure they are getting the best coverage for their clients through the insurance company. So, we’re trying to work things out, it’s really very interesting and yes, as I mentioned, it’s a little serious. (piano music) But also a little happy.

Anyways, thank you so much for watching. I hope you enjoyed this. Please give me feedback, give me some feedback, I need some feedback. Tell me how it is, tell me if you’d like anything else changed so we can make this better for you.

Wanted: New Medicare Slogan

Wanted: New Medicare Slogan

 

 

Steve Shain: Hey everybody, welcome back. So, I got a lot of shout outs today, I’m just giving you a heads up right at the beginning. A lot of people to thank for this video, just because they had some good ideas and I’m trying to implement them into today’s video. First of all, thank you to Jerry Freedman for recommending that we put the text down at the bottom for those people who are not listening but are actually just reading along with the video. Honestly, I don’t really understand why you wouldn’t blast the volume on really loud so everybody could enjoy what we have to say here but I guess it’s your prerogative. For you guys that are not listening, you got the text here on the bottom. Thank you, Jerry.

Second shout out goes to Yehuda Davis, he mentioned to us a while back about this change and it’s actually going into place. So thanks Yehuda for this tip-off, which I’d like to share with everybody else as well if you did not already hear. New York Medicaid used to obviously be working with MLTC plans – managed long-term care plans – so the managed long-term care plans were covering the long-term care patients in the skilled nursing facilities. What’s happening now is that a rule has gone into place that the MLTC plans only need to extend for three months – 90 days – after that a long-term care patient can disenroll from the MLTC plan and revert back to straight Medicaid. That’s right, they can go back to straight Medicaid, providers will be billing Medicaid directly, communicating with Medicaid directly and the MLTC plans will no longer be covering the resident after three months in the facility. This is actually great news for everyone. It’s good for the providers because providers don’t need to work through a middleman like MLTC. They can work directly with Medicaid. It’s also great for the MTLC plans in a way because they have members of the insurance as a whole and the more complex ones are the ones that are constantly institutionalized, so now that those members are being disenrolled, it kind of makes their job easier for the members that they do need to care for. So it sounds like a real win-win but I’m not sure how Medicaid feels about this, but you know, it’s going back to how it used to be so I don’t really see a problem with that either.

Now there’s one thing that I’m not sure everybody does know about and that is Medicare’s soul-searching that they’ve been doing recently. Medicare was established in 1965. At the time, the concept for what Medicare was there for was to provide care for coverage that was “primarily health-related.” That was their tag line, anything that’s “primarily health-related” is what Medicare covered for Medicare recipients. Now, that was a long time ago. What seems to be happening now is that the folks at Medicare got together and they’re scratching their heads and they’re like “This doesn’t seem right. If our coverage is for ‘primarily health-related’ care, we should be covering more.” And that’s exactly what they’re looking into. And at the same time the Medicare Advantage Plans, which is the insurance plans, that are replacing Medicare, are looking into this as well. Because if the coverage should be “primarily health-related,” it should really be expanded to more services and more kinds of healthcare settings. So to give you some examples of things that are being speculated; nutritious food, transportation to health-related services, independent living, assisted living, adult daycare, other healthcare settings are now considered for Medicare reimbursement. This is an extremely exciting idea for healthcare providers, this is something that they plan on putting in place in 2019, which is not too far away. We’ve actually been in talks with a lot of the national healthcare insurers that are working with us to try to figure out exactly how they can provide services to Medicare members and in what avenues they can now cover. So hold on tight for 2019, we’re expecting that some of these services in some of these avenues will be covered, but hold on tight, it’s not determined yet.

So for the last shout out, I want to give a shout out to Seema Verma at CMS. Your tagline is “primarily health-related” for Medicare. Come on, you can do better than that, I’m going to give you two suggestions and whoever is watching this please put in the comments any other suggestions you think the Medicare tagline should be. I’m sure we can do better with what they have right now. So here’s my two suggestions, they’re not awesome but it’s a start; Medicare – You Paid Into It, Now Cash Out. You like that? How about this one; Medicare – We Keep Your Providers Happy So They Can Keep You Healthy. Right? You like that one, I see you like that one. If you have anything better, put it in the comments and I’m going to take it, stuff it in an envelope, mail it to Seema Verma, and hopefully we can trademark something really quick. Of course, if you have questions, comments, or anything you think can make this video better, please let us know so we can make this better for you. Take care.

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Transcript:

Here we go 2018. If you’re like the most of us here, you probably were covered in snow for the first part of this month and finally just creeping out of it. Or you’re one of those people that completely avoided it – you were in beautiful weather – and you were the ones sending screenshots to your friends of the beautiful forecast you had for the rest of the week, getting us all jealous. Thank you, that was really great. No, it brightened our day, thanks!


Either way, whoever you are, it’s the beginning of the year it’s January. It’s like that fresh snow is out there, nobody stepped on it yet, we like to just keep it positive, keep that holiday cheer going a little bit longer. So for this video I’m going to give everyone some good, positive stories coming out of our industry. So hopefully it’ll brighten up your day a bit.


No. 1 – we have out of Connecticut. There was a pending budget cut for the Medicare Savings Program. Medicare Savings Program was in place by the state in order to help many Medicare beneficiaries – senior citizens – that were getting coverage for their Medicare part B premiums, for some co-pays, deductibles, a lot of out of pocket expenses. And this budget cut that was going into place was going to change the eligibility standard for this program and therefore, many, many seniors were going to lose that coverage. In the beginning of this month, the state announced that although it was going to make about $70 million in savings by going ahead with this budget cut, it was also going to make about 113,000 seniors really, really mad. That was not something that they were just able to pull off, and therefore, they announced that they were keeping everything status quo. The same eligibility standards that were in place are going to stay in place and everybody gets the coverage that they were expecting. So, I don’t know what they’re going to do about that big gap in their budget but maybe a suggestion is don’t try to pass a budget cut that has so much pushback from the whole state. But that’s just a suggestion. I thought that was great news.


Now, I saw in the New York Times this morning an interesting story about hospitals that are losing patience. Many hospitals are losing patience. And they’re running out of patientce because they’re waiting and waiting, the doctors are waiting, for medication to be coming in and the medication in not arriving. When they finally get this medication, the prices are extremely expensive, skyhigh costs, and did you get my joke by the way with the patience thing, I was talking about the other – oh you got it – ok good, I just wanted to make sure, I wanted to make sure you got my joke. The medication is very hard to get and when they finally get it it’s really expensive. They said you know what, let’s pull a page out of the Uber playbook and let’s just cut out the big guys and go straight to the source. So that’s what they did, they got about 300 hospitals together, they went straight to the manufacturers of the medication and they said we want to get these generic medications on our own at a very reasonable cost so we can distribute it to our patients. And that’s exactly what they’re doing. The FDA is actually backing this as well, and it’s going to make available as this thing moves ahead, medication, much more medication, at much more reasonable pricing, which is something that’s really great news for all the other news that we’re hearing about medication prices being sky high and just ridiculous.


Lastly, we have out of Syracuse, New York, actually an LTC client that took over a healthcare facility Bishop Healthcare, Mr. Ed Farbenblum. When they came in, one of the first things they did was announce that they were committing to a $1.5 million salary raise for the nurses and the nurse’s aides in the facility. It made the local news, it was really exciting, and obviously getting started off on the right foot by having the staff happy and appreciative and that spreads to the rest of the facility. So great job Ed and we wish you the best of luck.


And I hope that these stories will keep you smiling, even if your friend sends you one of these-while you’re stuck under the snow, you’ll still be good to go. So until next time, thank you so much for watching and keep warm!