Denise McQuown-Hatter, President and CEO of Affinity Health Services, and Sheila Capitosti, Vice President of Compliance Services with Functional Pathways, will be presenting at the 2018 LeadingAge PA “Focus on the Future” Annual Conference, held at the Hershey Lodge from June 20th to June 22nd.
Date of Event:
Wednesday, June 20th 2018
“Opportunity In A Fog Of Uncertainty”
Leadership & Strategic Positioning
1) Identify common threads among alternative payment models
2) Evaluate impact of implementation of new models and the challenges facing providers and beneficiaries
3) Explore next steps for all providers to prepare for implementation of new models of reimbursement
Skilled nursing facilities have experienced the effects of numerous alternative payment models in the past couple of years including but not limited to ACOs, Bundle Initiatives and Medicare Advantage organizations all of which have led to an emphasis on preferred providers and narrowing of networks to include those who can demonstrate the best financial and clinical outcomes for Medicare beneficiaries. But the fog of uncertainty is not over by any means. CMS has issued an Advanced Notice of Proposed Rule-Making announcing that it plans to propose payment reform effective October 2018 (FY 2019). The proposed payment reform model, known as Resident Classification System Version 1 (RCS-1) eliminates therapy minutes as a driver of reimbursement rates and has the support of MedPAC and the OIG. The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, required MedPAC to develop a unified pay system spanning the four post-acute care settings, and MedPAC’s June 2017 report recommended that Congress direct Health and Human Services (HHS) to implement a system for post-acute care beginning in 2021 with a three-year transition. In their December public meeting, MedPAC recommended that Congress should direct HHS to begin to base Medicare payment to post-acute care providers on a blend of the setting specific relative weights and unified post-acute care prospective payment system relative weights in fiscal year (FY) 2019. MedPAC staff suggested that a blended system could be used in 2019 and 2020 until a transition to a unified post-acute care pay system begins in 2021. Regardless of what the reformed payment model will look like, it is clear that reform is indeed not an uncertainty. The opportunity lies in identification of common threads among all the payment models and preparation for success in a new era of care delivery and reimbursement.