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), 4.00 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.

  • PDPM 101 - Introduction to the SNF PPS Patient-Driven Payment Model (PDPM)

    Contains 2 Component(s) Recorded On: 10/02/2018

    This presentation provides an introductory overview of the new Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) payment model that will be implemented on October, 1, 2019 (Fiscal Year 2020). Specifically, the current Resource Utilization Groups, version IV (RUG-IV) per-diem case-mix payment model, which is based on resident characteristics and therapy utilization, will be replaced by a Patient Driven Payment Model (PDPM), which is based solely on resident characteristics. This represents the most significant change in how SNFs are paid since the SNF PPS was first implemented in October 1998. This presentation describes the motivations for the Centers for Medicare and Medicaid Services (CMS) to change the SNF PPS payment model, the basic design of the PDPM payment model, the specific patient assessment payment drivers and their impacts on payment rates, and the AHCA member support activities to help members prepare for PDPM implementation.

  • 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.

NCAL AHCA