Why would anyone mention value-based reimbursement, medical necessity and the Jimmo lawsuit in the same sentence? I feel they are all related, but it will be difficult to find the perfect balancing act to maximize the benefits of each topic.
Most nursing home administrators do not believe that pay-for-performance initiatives lead to improved resident care or stronger bottom lines, according to findings recently published in the Journal of Aging and Social Policy.
Long-term care providers have a stronger hook than they probably realize regarding the toughening of penalties for hospitals with high readmission rates.
Many states are at the forefront of pay for performance initiatives. These tie payment incentives to quality measurements and outcomes. These programs are encouraged by the Centers for Medicare & Medicaid Services' value-based purchasing "Pay for Performance" initiative.
Skilled nursing facilities could see reimbursements tied to their number of hospital readmissions starting in 2018, under Medicare legislation announced by House and Senate leaders Wednesday. The bill also would delay the transition to the ICD-10 coding system for a year and prevent scheduled payment cuts to physicians.
The U.S. system for providing long-term care should be changed to reduce the number of people living in facilities and better align spending with health outcomes, according to comments that state Medicaid directors sent to the Congressional Commission on Long-Term Care.