PDPM and Non-Therapy Ancillaries The non-therapy ancillary (NTA) part of the patient driven payment model (PDPM) is considered by most people I’ve talked to as being better than what we’re currently doing. It more accurately accounts for expenses and isn’t overshadowed by therapy. In this post I’m going to take a deeper look at it… Continue reading PDPM Non-Therapy Ancillary Pay
Tag: reimbursement
Tennessee Medicaid
Case-Mix In Tennessee Tennessee has announced its intention of moving towards the 48 RUG grouper for Medicaid in skilled nursing facilities. This post is intended to be a reference about the 48 grouper you’ll be using in Tennessee. You are in good company The 48 grouper is used by quite a few states. Its use… Continue reading Tennessee Medicaid
PDPM, Let’s Do Some Math…
PDPM (Patient Driven Payment Model) aka RCS v2, aka RCS lite, aka Provider Driven Payment Model (my personal favorite), aka the worst thing ever for therapy, etc. I remember when PPS (Perspective Payment System) came and many thought this was the worst thing ever for therapy. Many companies declared bankruptcy. (The one I worked for… Continue reading PDPM, Let’s Do Some Math…
SNF Part A LOS – 2017
Part A Length of Stay – All SNFs Nationwide The PDPM enhanced data set has enough information in it to calculate length of stay at the facility level for Part A for 2017. Naturally we’re interested in length of stay so we did a little analysis which we’ll share here. First, let’s look at the… Continue reading SNF Part A LOS – 2017
PDPM – Section GG Functional Scores By State (& County!)
The enhanced provider specific file for PDPM released by CMS has given us an unusual opportunity to study and understand things going on in our industry in a much more timely manner than we’re accustomed to. Let’s hope this trend continues. In this post we’re going to be looking at the new functional scoring technique… Continue reading PDPM – Section GG Functional Scores By State (& County!)
PDPM – Nursing Categories
CMS has released a provider specific impact analysis for PDPM using 2017 data. There’s a lot to analyze and that takes time. However, one interesting question we can answer with the data is something along the lines of “What would happen if all the therapy minutes disappeared?” (Note: Since CMS still refers to the nursing… Continue reading PDPM – Nursing Categories
PDPM Calculator Available!
We’ve just released the PDPM Calculator! (We’ve also retired the RCS-1 Calculator since that proposal is effectively retired. You can still access that calculator here if you want to compare or you’re feeling nostalgic.) Why build a PDPM calculator when CMS released their own Excel-based grouper tool? We felt like the Excel tool was a… Continue reading PDPM Calculator Available!
Q1 2018 North Carolina Medicaid
“You can’t manage what you can’t measure” The latest data from the state of North Carolina has been published. We spend considerable time carefully studying the data here at Broad River. It’s like a second report card that we get every quarter. (Obviously the most important report card comes from the customer.) This data tells… Continue reading Q1 2018 North Carolina Medicaid
MPPR Calculator
We’ve just released an MPPR calculator that you can use to see how much difference MPPR makes to your Part B billing. The rest of this post is going to be about features and how to use the tool. If you’d prefer to get right to it, the calculator is here. You can also get… Continue reading MPPR Calculator
MPPR: A Hidden Expense
Although MPPR has been around since 2011, a lot of people are surprised just how big a role it plays in Part B reimbursement in skilled nursing. It’s a tool CMS has used to justify paying less for Part B therapy delivered in skilled nursing facilities. Here’s how. How Part B Used to Work Back in the… Continue reading MPPR: A Hidden Expense