Headlines

SNFs Prepare For Rising Acuity Of Patients

Skilled facilities and hospitals are observing patients with higher complexities being discharged to SNFs much sooner. Because of this, SNFs are trying their best to prepare for the rising acuity of patients coming in. This article from @skilled_nursing details the variances seen by geographic location, challenges expected and suggestions on how SNFs can partner with

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What Is PDPM?

The Centers for Medicare and Medicaid Services (CMS) will soon be replacing the Resource Utilization Group (RUG) Version IV payment model with the new Patient Driven Payment Model (PDPM). The current RUG-IV system focused on payments based on how much therapy services were received. However, PDPM places patients into case-mix groups based on certain clinical

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CMS Requested To Simplify Three-Day Stay Rule

Currently, Medicare beneficiaries must have a three-day hospital stay to receive subsequent fully covered skilled nursing services. Hospitals admitting on an observation basis rather than inpatient has lead to very costly Medicare denials. The American Health Care Association (AHCA) CEO has asked Centers for Medicare & Medicaid Services (CMS) to eliminate uncertainty on the Medicare

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MA Growth Of The Five Biggest Payers

Managed Care is growing! Here is a look at the increase the five biggest Payers have seen in Medicare Advantage membership in the last year. Aetna leads the pack with an over 30 percent increase over last year. See the article below for this and more.   View Article Here

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Payers Watch Rehospitalization

Rehospitalization is the most closely tracked metric for all payers. A recent Dartmouth study reduced RTH by 31%, predominately for LTC residents. For more on this, see this article from @mcknightsltcn: View Article Here

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CMS Will Help MA Plans Become More Competitive

CMS has announced a new rule that will help Medicare Advantage plans to better compete with one another. This competition will be possible due to the types of benefits they will be able to offer next year including transportation, home environmental improvements and many more. For more on this, read the @HeartlandInst article below. View

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