In 1775, the chant of the day was “The Redcoats are coming! The Redcoats are coming!” Fast-forward to 2019 and in the realm of skilled nursing providers, the popular refrain is “PDPM is coming! PDPM is coming!”
The new Medicare fee-for-service reimbursement model known as Patient Driven Payment Model (PDPM) will drastically change how reimbursement will be determined. In the past, the Resource Utilization Groups (RUG-IV) have determined reimbursement, in which the amount of therapy a resident received played a significant part in the amount of reimbursement the facility received for that resident. Reimbursement will transition away from the volume-based payments of RUG-IV toward the new PDPM model. With PDPM, ICD-10 codes will be a crucial driver for reimbursement.
Trepidation, fear and confusion have all been experienced by minimum data set (MDS) coordinators and staff alike at various long-term post-acute care (LTPAC) facilities regarding selecting and/or having to code diagnosis for residents—especially upon admission. Some common questions include: “What do I choose?” “How do I know if it is the correct primary or admitting diagnosis?” “I’m not a coder—how do I know what diagnosis to choose?”
Revenue cycle management (RCM) is so much more than just a financial process. It is about the procedures that enable your long-term post-acute care (LTPAC) organization to maintain a positive financial picture and, in turn, allow you to focus on day-to-day operations and optimal outcomes. It sounds cliché, but that is why communication is key throughout the RCM process. Poor communication at any point can cause a complete breakdown.
With a new year underway, it’s important for accounting and finance professionals in all long-term post-acute care (LTPAC) settings to be aware of reporting updates that may have slipped your mind while getting through year end. In 2016, The Financial Accounting Standards Board (FASB) issued a previously proposed update (ASU 2016-14) that will affect nonprofit entities. The time has now come to get familiar with the details of this update, as it is effective for fiscal years beginning after December 2017.
If your long-term post-acute care (LTPAC) organization’s strategic approach to revenue cycle management doesn’t marry business performance with customer service and outcomes, you could be headed for divorce court.
Accounting and finance professionals are currently in high demand across a wide range of industries, and the long-term post-acute care (LTPAC) industry is no exception. As a result, this makes it difficult for LTPAC providers to attract and retain qualified in-house controllers.
The experience, insights and expertise of a qualified controller are essential to maintaining current quality levels, ensuring profitability, and enabling future growth. So, how do you know if your LTPAC organization is in need of a contract controller? Ask yourself these questions:
The long-term post-acute care (LTPAC) industry is bracing itself for yet another major change in 2018: Resident Classification System-1 (RCS-1). This new Medicare payment model is only months away, with an estimated start date of October 1, 2018. RCS-1 has the potential to turn things upside down for providers that are not sufficiently prepared.