A new federal review process designed to lower the rate of improper government payments is sending provider staffs scurrying to justify their coding.
MDS meets VBP: I love a good value, don’t you?
By
Joel VanEaton
Oct 10, 2022
I love a good value, don’t you? It’s hard to find one these days in this economy. Recently a friend of mine purchased a used vehicle from a reputable local dealership. Within a week, the engine...
Ready, set, review!
By
Renee Kinder
May 11, 2023
We’ve all been waiting for this. We knew it was coming! What am I speaking of? The May 4, 2023, notice of Skilled Nursing Facility (SNF) 5-Claim Probe and Educate Review, of course! Since the initiation...
Final pay rule and rates: A primer for rehab professionals
By
Renee Kinder
Sep 01, 2022
The October 2019 industry shift to the Patient Driven Payment Model allowed all rehabilitation professionals the opportunity to document specific clinical characteristics about the patients we serve and...
Guess what’s coming to nursing homes next
By
Kimberly Marselas
Apr 03, 2024
I remember when the Patient Driven Payment Model rule was just a proposal inching its way toward finalization, its concept of assigning points for specific non-therapy ancillary costs a pretty exciting...
Ask the payment expert … about MDS payment implications
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Sep 12, 2023
Q: Are changes to the Patient Driven Payment Model expected with the revised MDS in October?
Providers ‘on notice’ as CMS pressures states to shift Medicaid pay metrics
By
Kimberly Marselas
Nov 10, 2022
Providers still struggling to accurately capture diagnoses that drive federal reimbursement will be doubly left behind as more states start to use Patient Driven Payment Model-like systems to determine...
CMS eyeing PDPM case-mix additions, changes
By
Kimberly Marselas
Apr 24, 2023
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...
Unraveling the impact: PDPM Medicaid case-mix index and potential Five-Star Rating challenges
By
Steven Littlehale
Mar 01, 2024
The landscape of Medicaid reimbursement for nursing homes is undergoing significant changes. Presently, eight states have adopted the PDPM case-mix index (CMI) model, and an additional 31 states are set...
Need a PDPM boost? A new study points to physiatrists for $34,000 monthly kick
By
Kimberly Marselas
Oct 20, 2022
Physiatrists can help skilled nursing facilities more accurately capture reimbursement under the Patient Driven Payment Model, a leading payment consultant said Tuesday.