Steve Shain shares the latest healthcare trends, news and policy updates. LTC Consulting Lens is a great way to keep on the pulse of the Healthcare business world, without searching further than YouTube.
It’s funny that you’re thinking I colored that…but also this à People got bored of reading so we found a better way to get your attention – VIDEO!
It’s funny that you’re thinking I colored that…but also this à Now video’s becoming boring too! So here’s a twist, a video you gotta read. This also saves us loads of $$ on subtitle creation (that was a lie)
Have you noticed this new trend in healthcare news? Healthcare facilities are starting to go high class. Providers are upping their game big time.
It’s funny that you’re thinking I colored that…but also this à From theaters and recreation to saunas and spas, or Free Wifi and Amazon Alexa. 1 boasting this: Princess Diana’s personal chef Darren McGrady. Another, a well known hotel exec: Former President of The Ritz Carlton Horst Schulze. What do you think is driving this new healthcare trend? I’ve got my own thoughts…but people are definitely bored of those! (that was not a lie)
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.
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.
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.
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.
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.