Reimbursement

  • Replacing RUGs – CMS’ New SNF Payment System & How to Get Ready (a video recording from the 2019 AHCA Convention Intensive)

    Contains 9 Component(s), 4 credits offered Recorded On: 10/10/2018

    The Patient-Drive Payment Model (PDPM) is now final with implementation scheduled for October 2019. AHCA’s educational approach to PDPM will be to offer a holistic picture of how PDPM impacts SNFs and will incorporate PDPM interactions with: • Requirements of Participation, • Survey and Licensure, • SNF Re-Hospitalization Measure Value-Based Purchasing, • IMPACT Act Quality Reporting Program, and • Other payers’ (Medicare Advantage and Medicaid) and their probable responses to PDPM. In addition to in-depth training on the PDPM final rule, a member’s only tool kit will be introduced that will contain the core competencies framework and a readiness review tool that will help you track your operational readiness for PDPM. The intensive will also cover data gathered from 12 companies testing impacts of PDPM and provide hospital and discharge pattern data that could be helpful in member markets. Finally, a panel discussion of AHCA members will discuss opportunities and potential pitfalls for SNFs as they consider operational changes necessary to be successful under PDPM.

  • Quality Initiatives in Medicaid

    Contains 3 Component(s)

    Our quality-focused webinar will discuss quality initiatives in Medicaid. Included will be potential performance measure development in both fee-for-service and managed care environments. This webinar will also include Value-Based Purchasing, and the technical assistance AHCA/NCAL can provide.

  • Medicaid Financing

    Contains 1 Component(s)

    The purpose of this webinar is to map out the basics of how Medicaid is financed, including different opportunities states may pursue and state Medicaid matching pressures. It will include information on the Federal Medical Assistance Percentage (FMAP) and state match rates, provider taxes, intergovernmental transfers (IGTs), upper payment limits (UPLs) as well as supplemental payments.

  • Understanding SNF VBP in Detail

    Contains 32 Component(s)

    This course contains 6 modules that provide an in-depth description of each feature of the CMS Skilled Nursing Facility Value Based Purchasing (SNF VBP) program along with helpful tools and documents., and primary source reference to the program. This course covers how CMS calculates the 1) rehospitalization rates, including risk adjustments, 2) a facility’s performance score, and 3) the resulting incentive payment multiplier, which is used to adjust a facility’s Part A payments. -- The individual who wants to take the SNF VBP course must login to ahcancalED and register for the course under their individual login. For a better web experience, please use Google Chrome Internet Browser and NOT Internet Explorer.

  • How to interpret SNF VBP Performance Score reports

    Contains 3 Component(s)

    Center for Medicare and Medicaid Services (CMS) just released on August 2nd, 2018, the SNF VBP confidential reports that contains the payment adjustment factor to be applied to all SNF part A claims on October 1st, 2018 through September 2019. This payment adjustment factor may result in a decrease of up to 2% or increase up to 1.65% in your SNF Part A payments. This short video will use actual reports to discuss how to interpret your adjustment factor. it will also go over the SNF RM rates that will result in a payment cut, no cut as well as a payment increase. resources to access the reports are also provided. The presentation is a short video less than 15 minutes and also has a short set of power point slides as additional resource. Having a copy of your actual report, which you can access through the QIES portal in CASPER will be helpful.

NCAL AHCA