A new non-profit society aims to improve education for purchasing directors at post-acute facilities, so they can make better decisions for both the bottom line — and for their long-term future. The approach the organization — the Society for Healthcare Organization Procurement Professionals (SHOPP) — is taking is two-pronged, according to Ari Stawis, director of […]
Zimmet Healthcare Services Group
The new year is barely a few days old, but leaders across the post-acute and long-term health care space have already predicted an active — and potentially distress-filled — 2020. As the industry adapts to a new Medicare payment model, the pressures that have bogged operators down over the last few years will continue, from […]
Early PDPM Claims Data Reveals Far More Winners Than Losers, ‘Impossible Combinations’ of Conditions
The first round of claims data under the new Medicare payment model for nursing homes shows that the majority of operators are seeing reimbursement boosts — while some are also making key billing mistakes that could result in missed payments for certain services. The average skilled nursing facility saw Medicare reimbursements of $614.96 per patient […]
Skilled nursing providers looking for a simple answer to how managed care plans will react to the new Medicare payment model will likely have to face an inconvenient truth: It’s complicated. Private Medicare Advantage insurers didn’t have to follow the old Resource Utilization Group (RUG) model when deciding how to reimburse for skilled nursing services, […]
Faced with a sea change in the Medicare reimbursement system for nursing homes, operators have spent the last year asking a key question about their therapy offerings: outsource or in-house? And if the answer is outsource, what will that relationship look like moving forward in unfamiliar payment landscape? There’s no one correct answer for contract […]
Data continues to be the watchword in a skilled nursing marketplace where hospitals and other referral partners demand increasingly concrete information about post-acute outcomes. In response, numerous tech companies have stepped into the fray to provide potential solutions — from data analytics tools that can identify serious health issues before they escalate to a hospitalization, […]
Skilled nursing operators frequently bemoan the shorter lengths of stay and lower daily payment rates for Medicare Advantage residents, but the leader of one plan says it’s also up to providers to present novel ideas to insurance executives. Before taking the CEO role at the nursing-home focused Longevity Health Plan earlier this year, René Lerer […]
The new Medicare payment model for skilled nursing facilities has consumed most of the oxygen around the industry over the past year-plus, with operators, vendors, and consultants working in tandem to adjust to the new math. But according to one leader, all of that attention on the Patient-Driven Payment Model may not be focused on […]
Accurately diagnosing and treating depression could bring significant rewards for operators under the new Medicare payment model for nursing homes — both financially and clinically. Training frontline caregivers to notice the signs of depression among residents of skilled nursing facilities will be vital to success under the coming Patient-Driven Payment Model (PDPM), according to Zimmet […]
Several states across the U.S. have eyed managed long-term services and supports as a way to reduce their Medicaid spend, but the state of New York — which made the move in the early part of the decade — is now taking a step back. Specifically, the Empire State is looking to move the long-term […]
Risk-sharing has loomed large in health care reform efforts over the last decade, and the new Medicare payment model for skilled nursing facilities could open up additional avenues for operators to take control — along with pointed questions from partners along the spectrum. The Patient-Driven Payment Model (PDPM) marks a step toward a long-teased site-neutral […]
The market will still need to determine whether the new Medicare reimbursement structure for nursing homes will be a net positive or negative for the industry, but at least one insider says buyers and sellers in the space aren’t optimistic enough. Current prices for skilled nursing facilities don’t typically account for the potential of cost […]
At surface level, the new Medicare payment model for nursing homes revolves largely around therapy, as the federal government works to realign incentives and prevent what officials claim to be a wave of unnecessary services. Speech, occupational, and physical therapy account for three of the five components of the Patient-Driven Payment Model (PDPM), and providers […]
When it comes to the changes coming to Medicare reimbursement methodology, coding figures prominently in the discussion among skilled nursing providers. But while it’s important for SNFs to make sure staff education and training on that topic is up to date, there are several other components of reimbursement under the Patient-Driven Payment Model (PDPM) that […]
With a new Medicare payment model for skilled nursing facilities just months away, operators who haven’t started planning for the changes are already months behind. Skilled Nursing News has been reporting on the new Patient-Driven Payment Model (PDPM) since the day it was finalized last July 31, and we’ve spent those eight months speaking to […]
Once the new Medicare payment model takes effect, frontline nurses may prove vital to securing the proper reimbursements for skilled nursing services. The Patient-Driven Payment Model (PDPM) will place increasing pressure on nursing facilities to justify each resident’s need for Medicare-reimbursed skilled care, Zimmet Healthcare Services Group president Marc Zimmet said during a recent industry […]
In the lead-up to Christmas and New Year’s, the Skilled Nursing News team took a shot at predicting what 2019 will have in store for the industry over the coming 12 months. Now that the ball has dropped and we’re all back at our desks, we thought it was the perfect time to ask a […]
At face value, the statistics look grim: Nearly three-quarters of the nation’s skilled nursing facilities will see pay cuts in 2019 under the government’s value-based purchasing (VBP) program after failing to reach mandated readmission benchmarks. But the numbers themselves don’t tell the full story, according to players in the long-term health care space. Based on […]
A majority of skilled nursing and seniors housing executives believe skilled nursing providers can no longer be independent players in the post-acute care continuum — and almost 20% see integration as a necessity. According to a survey conducted by real estate lending, investment, and advisory company Greystone and administered by Marc Zimmet of Zimmet Healthcare Services […]
As the long-term health care industry moves into a value-based payment world, a special type of Medicare Advantage plan could offer skilled nursing providers a path to get ahead. In fact, institutional special needs plans (I-SNPs) could be the future for skilled nursing facilities battered by the changes in reimbursement, the move to value-based models […]