Data is quickly becoming a must-have for skilled nursing providers looking to shore up their post-acute business. Post-acute patients generally have high-acuity needs that result in higher daily reimbursements, usually by Medicare. As some hospitals and Medicare Advantage plans increasingly bear more financial risk for these patients, they will seek partnerships with providers that can demonstrate their ability to provide a high level of care and potentially avoid costly rehospitalizations. With the entry of other risk-bearing entities, such as accountable care organizations, into the marketplace, the need to demonstrate value will grow.
The U.S. Government Accountability Office (GAO) concluded an investigation into Centers for Medicare & Medicaid Services (CMS) data on nursing homes, staffing practices, and financial performance by recommending that CMS make such data more easily accessible by the public and ensure the data’s validity. The agency’s report underscores the need for more and better financial skilled nursing data in the industry.
The push toward value-based purchasing by the Centers for Medicare and Medicaid (CMS) means significant changes for operators, said Ray Thivierge, a well-known and respected skilled nursing industry leader. He moderated “The Ever-Changing World of Skilled Nursing: The Impact of CMS Initiatives,” a session at the 2016 NIC Fall Conference in September.
With so much uncertainty about the changing health care payment and delivery system, can operators create new successful business strategies that attract investment, or is that just a dream on the far side of the rainbow?
On September 24, the Centers for Medicare and Medicaid (CMS) released a final rule that increases regulations on nursing homes that care for Medicare and Medicaid residents, as the vast majority of skilled nursing providers do. One of the regulations—the “headline” for many in the media—is the prohibition of arbitration clauses in new resident contracts.