With Medicare Advantage revenue “significantly lower” than fee-for-service reimbursement, a new Zimmet Healthcare Services Group analysis says, skilled nursing facilities need to weather today’s “reimbursement storm” in order to make it to the incoming wave of baby boomers that will need facility services. In the meantime, Zimmet suggests operators utilize … Read More
The Rime of the New World Mariner Medicare Advantage & SNF Reimbursement
It is a New World Mariner, And he stoppeth wounded knee, With long grey beard and rehab needs, Now wherefore stopp’st thou he? Data, data everywhere, Still all our rates did shrink, Data, data everywhere, Yet all of it doth stink. Oh Fee-for-Service Medicare, How little hath we seen, Advantage … Read More
To Get Ahead of PDPM Audits, Skilled Nursing Facilities Target Top Areas of Payment Focus
When the overhaul of Medicare Part A reimbursement for nursing homes took effect in October 2019, predictions of audits and the potential for drastic changes came close on its heels. After all, the Patient-Driven Payment Model (PDPM) was meant to be revenue-neutral, meaning that the Centers for Medicare & Medicaid … Read More
Voices: Marc Zimmet, Chief Executive Officer, Z-CORE Analytics
You are the CEO of Z-CORE Analytics, and you’ve had a long career beyond this. What are the origins of your work with Z-CORE? I’ve been in the skilled nursing space for almost 30 years, all with a concentration on reimbursement-compliance. When I started my career, Medicare payment was driven … Read More
Despite Hands-Off Approach from CMS, PDPM Pitfalls Remain for Nursing Home Operators, Investors
“What’s the potential compliance target from a third-party auditor? It’s anything that makes your rate higher, and anything that you’re an outlier in,” Vincent Fedele, chief operating officer at CORE Analytics, said Tuesday during SNN’s virtual Payments, Policy, and Capital Summit. Click here to read the entire article