The Patient Driven Payment Model is a rare bright spot in Skilled Nursing’s dreary reimbursement landscape, but storm clouds are on the horizon. CMS has proposed recalibrating SNF rates to correct for unintentional spending relative to the RUG system it replaced. The agency refers to this reduction as a “Parity … Read More
Analysts break ground with first batch of SNF Medicare Advantage data
Managed care plans typically hold all the cards when it comes to rate-setting. But a new way of analyzing billing data could finally give increasingly leveraged providers a better leg to stand on, financial experts say. The new analysis breaks out the data by per diem rate, length of stay, … Read More
The CORE Reporter: New perspective, better data
Medicare claims (UB-04s) are an invaluable source of SNF data. CMS releases quarterly “LDS” claim files which allow for Medicare utilization and market analysis. Third-party vendors offer useful tools that quantify referral patterns and performance metrics, but the data falls short in two critical ways. The first is timeliness; healthcare … Read More
PDPM: 4 simple steps to optimal coding
Accurate coding has always been a key foundation for maximizing reimbursement. Success under PDPM will require more than just accuracy, however. To achieve long-term PDPM success, you’ll need to implement some essential PDPM coding practices at your facility. Want to optimize your coding practices before PDPM becomes a reality on … Read More
[On-demand webinar] PDPM in the real world: Solutions and case studies
Don’t miss this unique opportunity to learn practical, real-world tips for PDPM preparation. By now you know “what” and “why” of the new Patient-Driven Payment Model, but what about the “how”? How can you ensure accurate diagnoses, manage changing per-diem rates and avoid the specter of audits? How can you … Read More
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