2023 SNF PPS Recalibration Adjustment

Ken BellCORE AnalyticsLeave a Comment

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

Ken BellCORE AnalyticsLeave a Comment

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

Ken BellCORE AnalyticsLeave a Comment

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