Federal regulators are weighing changes to the three-year-old Patient Driven Payment Model to account for missed opportunities — and potentially inappropriate coding choices — a top Medicare official...
Medicare Advantage plans forcing providers to take ‘optional’ payment reductions
By
Kimberly Marselas
Nov 15, 2022
Many skilled nursing providers are still underusing Interim Payment Assessments under the nascent Patient Drive Payment Model, but one new pressure is driving some to submit those extra patient evaluations...
Data expert strips down PDPM myths, truths
By
James M. Berklan
Feb 25, 2019
Long-term care professionals have been diligently cramming to prepare for a new skilled nursing reimbursement system in October, but a data expert had a sobering observation for presentation attendees...
BREAKING NEWS: CMS gives skilled nursing 2.4% Medicare pay raise, unveils another new resident classification...
By
Kimberly Marselas
Apr 27, 2018
In a flurry of activity late Friday, the Centers for Medicare & Medicaid Services announced an $850 million pay raise for skilled nursing facilities for fiscal 2019 that comes along with major simplifications...
Danger ahead?: SNFs face potentially steep cuts as CMS considers changes to PDPM, VBP program
By
Danielle Brown
Apr 12, 2021
A recalibration to the Patient Driven Payment Model could have troubling payment implications for skilled nursing providers who are still trying to manage a difficult operating environment caused by the...
‘Audits are back,’ and COVID-19 care is in the hot seat
By
Kimberly Marselas
Apr 21, 2021
Flexibilities granted to providers during the ongoing public health emergency are likely to result in increased medical reviews and automated denials, a therapy billing specialist is warning.
Therapy carnage at start of PDPM not as severe as feared: study
By
James M. Berklan
Mar 02, 2021
The first academic study of its kind has found that the first three months of nursing homes’ overhauled Medicare payment system at the end of 2019 led to a distinct drop-off in the employed number of...
Keeping workers will be biggest struggle for nursing homes as pandemic persists, national policy expert...
By
Danielle Brown
Sep 30, 2020
Workforce challenges that have plagued long-term care operators during the coronavirus pandemic will get worse as the crisis further progresses this year, one of the nation’s top health policy analysts...
More than half of nursing homes missing out on PDPM, could lead to deals: expert
By
James M. Berklan
Jan 25, 2021
The federal government’s second-year Medicare payment system for nursing homes continues to be a boon for them, especially under pandemic conditions, but more than half are missing rightful reimbursements.