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...
The PDPM EDGE: New therapy model research study results
The top lessons learned from the AHCA’s 2021 Convention and Expo
By
Tamar Abell
Nov 05, 2021
Attending the American Health Care Association’s (AHCA) 2021 Convention and Expo this year felt like reuniting with friends after spending two years on the frontline of a battlefield. The...
Research those CMS dinner invitations thoroughly
By
James M. Berklan
Aug 13, 2021
I don’t know what was more shocking this week: A warning that federal regulators might actually double the amount they could trim from nursing home reimbursement rates next year or the way some veteran...
CMS let the cat out of the bag, but it’s managed care that’s ready to pounce
By
Kimberly Marselas
May 05, 2021
If you work with managed care (and who doesn’t anymore), chances are pretty good you’re already on a collision course that’s been accelerated lately
Spring cleaning 2021: Will your rehab team pass the white-glove review?
By
Renee Kinder
Apr 22, 2021
Spring is in the air. Time to open the doors, let some fresh air in, and clean above, under and between every surface in our homes. Spring is a season that allows my obsessive cleaning habits to become...
‘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.
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...
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...