I’ve begged my friends who own home healthcare assets to get out. Sell. And all but one (way to go George) told me that they had too much upside in the business to consider selling now. Lesson #1 when running a healthcare company. Sell before major regulatory change. Sell when margins are too high to be sustainable — no one is good enough to make up for it in volume without MANY years of additional work. Sell when someone wants to buy your business — for when the day comes that CMS targets the industry, then NO ONE will be a buyer. Amedisys is the poster child for the most recent CMS and Congressional action. They have been accused of creating care plans with one eye on the reimbursement rules. Get to a certain threshold of visits, and reimbursement rises substantially. One visit less than the threshold and no bonus. Guess what? CMS thinks the industry is making sure the patient gets the one last, and arguably unnecessary, visit so the home health agency gets the higher payment. OF COURSE THEY DO. Wouldn’t you? One more treatment will help, not hurt the patient. Yet when the payment system is set …
Senate Finance Committee progress
The Senate continues to work in getting a bill ready for the floor. The Senate Finance committee vetoed two attempts to add the public option and as they wind up their bill a public option will be excluded. The Dodd/Kennedy bill has the public option and it will be up to Henry Reid to determine what will be in the bill that goes to the Senate floor for a vote. The Senators that tried to amend the Senate Finance Committee bill yesterday have publicly stated they have more than 50 votes to pass a public option in the Senate. That would require a reconciliation bill and it is unclear whether or not the parliamentarian for the Senate would allow a provision that may not be seen as a budget item. If he agrees that a new government health plan can be part of a reconciliation bill, then it is possible that the Senate passes a bill with a public option. This will continue to play out over the next couple of weeks. In the House there has been silence which may mean that Pelosi still doesn’t have the votes to bring a bill to the floor. At one point she …