Hospital readmission rates have emerged as the unquestioned arbiter of post-acute care quality and payments. But a new study suggests a more comprehensive approach may be warranted.
CMS: Medicare rate will increase 2% in 2015, boosting skilled nursing facility reimbursements by $750 millionMay 02, 2014
Medicare would increase skilled nursing facility reimbursements by $750 million in 2015 under an updated payment rate proposed Thursday. CMS also will begin tying reimbursements to new statistical area designations set by the Office of Management and Budget.
President Barack Obama signed legislation that ties skilled nursing facility Medicare reimbursements to hospital readmissions, starting in 2018.
The White House's proposed 2015 budget includes sharp cuts to skilled nursing facility reimbursements, which has drawn strong criticism from the nation's largest long-term care provider group. To cut federal spending on healthcare by $402 billion, the White House seeks to "encourage efficient post-acute care by adjusting payment updates for certain post-acute providers."
The Centers for Medicare & Medicaid Services should hold off on updating Medicare skilled nursing facility reimbursement rates due to potential problems in its calculation methods, the American Health Care Association stated Monday.
Pressure on senior care providers to improve efficiency may be misguided, say Medicare cost researchersMay 30, 2013
Providers in areas with low average Medicare costs are not delivering care more efficiently than providers in high-cost areas, according to a new study. Prior studies said Medicare spending could be reduced by nearly a third if all providers adopted the practices of those in low-cost areas.
Improper coding related to activities of daily living is common, causing providers to lose significant Medicare reimbursements, a coding expert said during a McKnight's Super Tuesday webcast. "The biggest coding error I find is undercoding," said Mary-Beth Newell, RN, vice president of clinical reimbursement at Post Acute Consulting. "Undercoding is much more prevalent than overcoding."
Long-term care providers should treat residents holistically, rather than narrowing in on an illness, to reduce rehospitalization rates, researchers recommended recently.