CMS let the cat out of the bag, but it’s managed care that’s ready to pounce
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
Ensign execs see potential 5% PDPM cut as acquisition opportunity, concerned about CMS calculations
May 03, 2021
A recalibration of the Patient Driven Payment Model’s parity adjustment has several long-term care operators worried about potential steep cuts to skilled nursing reimbursements. But executives with...
As Medicare Advantage drives rate lower, fed-up CEOs embrace strategies that limit carriers’ influence
Apr 26, 2021
Medicare Advantage’s aggressive market penetration represents a major threat to skilled nursing providers, some of whom now find themselves clearing less per resident day through MA plans than they do...
Spring cleaning 2021: Will your rehab team pass the white-glove review?
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
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.
Is the doctor in? Improve nursing homes with one easy stroke
Apr 14, 2021
Many nursing home COVID-19 patients would have benefitted from daily, reimbursed-for physician visits in their skilled nursing facilities, but they were not entitled to them. With an epic crisis...
SNF payments could drop by $12 per patient day under potential PDPM recalibration
Apr 13, 2021
Skilled nursing operators are being encouraged to start analyzing their operations in order to prepare for a possible reduction in reimbursement levels if a recalibration to the Patient Driven Payment...
Danger ahead?: SNFs face potentially steep cuts as CMS considers changes to PDPM, VBP program
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...
CMS proposes 1.3% pay increase — with plenty of strings attached
Apr 09, 2021
A proposal that would boost Medicare payments to skilled nursing providers by 1.3% next fiscal year also could trigger additional reporting requirements and increase the potential for penalties.
BREAKING: Nursing homes slated for 1.3% — or $444 million — Medicare pay hike for 2022
James M. Berklan
Apr 08, 2021
Nursing homes would receive a 1.3% net Medicare increase for fiscal year 2022 under a proposal announced by the Centers for Medicare & Medicaid Services late Thursday afternoon.