Providers fire back on therapy billing

The current payment system for nursing home therapy is “flawed,” wrote American Health Care Association/National Center for Assisted Living President and CEO Mark Parkinson in a letter to the New York Times on Thursday.

Parkinson, along with American Physical Therapy Association President Sharon Dunn, wrote letters to the editor to give the providers' side to the recent story reporting on nursing home therapy overbilling.

Parkinson placed some of the blame on the Centers for Medicare & Medicaid Services, saying it doesn't provide guidelines on the quantity of therapy. He added that AHCA agrees the current payment system is “flawed,” and that it supports changes to the model.

“We are actively advancing a proposal to Congress and CMS for an improved payment structure that measures outcomes and better reflects the success of the therapy our members provide rather than just measuring the minutes provided,” Parkinson wrote.

Dunn stated that her organization believe volume-based payment systems should be replaced with value-based models, and it is working on ensuring that the “correct” incentives are being used when delivering care.

“We are working with industry to address volume-based care versus value-based care to improve compliance, help clinicians navigate complex regulation and payment systems and emphasize their responsibility to report unethical care provision,” Dunn wrote.