Direct Contracting is one of the newest, voluntary Medicare fee-for-service (FFS) risk sharing models aimed at transforming care delivery and moving providers from volume to value. Direct Contracting is based on lessons learned from ACOs and features of Medicare Advantage and encourages participation by organizations serving dually eligible and complex needs populations. It provides a potential path for innovative SNF/PAC providers to lead in managing risk. Join this webinar to learn more about Direct Contracting -- key features, participation options, beneficiary criteria, payment and quality, model waivers, and opportunity for SNF/PAC.

In this latest edition of AHCA/NCAL’s PRF Reporting education, member experts review the most up-to-date reporting requirements available as well as case examples. Members should use the information contained in this webex and update any work conducted based on earlier guidance.

AHCA’s PDPM Academy 2019 focused on the basic elements and technical aspects of the new patient characteristic-based payment model. In 2020, the AHCA subscription-based PDPM Academy will provide AHCA provider members with in depth on-line education and training on best practice topics and operational capacities key to PDPM success.

This webinar will provide a brief overview of the background of these important waivers and will also provide specific details about when and how it would be appropriate for SNFs to apply the waivers to assure that Medicare beneficiaries are able to access skilled SNF Part A benefits in a manner that also minimizes risks for unnecessary exposure or transmission of the COVID-19 virus. Examples of how the 3-Day Stay and Benefit Period waivers can or cannot apply in common situations will be discussed. Additionally, details related to documentation, MDS assessment scheduling, and claims coding and sequencing requirements specific to these waivers will be reviewed.

Historically, being “in network” with an MA plan was thought to be the optimal position. As MA plans have adjusted payments and operational requirements, being part of their network may not always be worth the administrative burden that continues to increase. The more complex it is to work with an MA plan, the more time staff must divert from their daily responsibilities. There is an opportunity cost and quantifying the costs associated with every contract, is part of the current imperative. Further, because of the growing penetration of varying MA plans in geographical locations, being in network with all MA plans in your location may no longer be necessary. What may be more important is deciphering which particular MA plans are the best for your organization, rather than taking a “contract with all” approach. This tool walks providers through the process for evaluating and understanding the real Return on Investment (ROI) of their Medicare Advantage contracts, ultimately assisting providers in determining whether remaining a network provider is worthwhile, or if other strategies may be more advantageous for both the provider and the residents.