Glasses of champagne and fireworks,new year celebration.
15th Dec

It is hard to believe but 2014 is coming to a close soon.  Compared to other Decembers this seems like a relatively quiet time.  I remember 1999 and wondering if the world was going to crash because of Y2K.  And then of course there is always the SGR and the expiration of the therapy cap exception process to deal with—usually wondering on New Year’s Eve if there will be another “fix” and extension.

This year it seems like we get a reprieve—the therapy cap exception process does not expire until March 31st and it even appears that there will be funding for the federal budget.  So let’s all relax and have a glass of champagne!!

But wait—2015 promises to bring continued challenges to us all.  Will there be a permanent fix to the SGR—will the therapy cap extension process be extended?  What will happen with the huge backlog of MMRs that have accumulated since the RAC pause in March of this year—will we be deuged with denials and appeals that will only add to the ALJ backlog?  Will ICD-10 really be implemented?

Will we see continued crunches on care and outcomes as managed care organizations continue to pressure for length of stay and diversion of beneficiaries to home and community based services?  Will there be more ACO penetration?

And we know work will begin on the value-based purchasing initiative for skilled nursing facilities tied to an all-cause hospital readmission rate.  Work will also begin on the standardized assessment for post-acute care providers that will surely result in a new payment system for skilled nursing facilities.

So on second thought should we really relax and have that champagne?  I say YES—absolutely!!  In fact, let’s have two or three.  And then, let’s get ready for the continued challenges and for a new year—let’s embrace what 2015 brings to us all!!

Sheila Capitosti

VP of Clinical and Compliance Services

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