TRIPLE CHECK & OTHER Medicare best practices, mhca 8/24/2015

1. TRIPLE CHECK & OTHER Medicare best practices, mhca 8/24/2015 Brian Hickman/Sherri Robbins/Julie Bilyeu

2. Agenda

3. Admissions

4. Determining cost of care

5. Consolidated Billing

6. technology

8. A/R Management

9. Increased payer scrutiny

10. Managing documentation risk areas for Skilled Care

11. Managing Skilled Care- Oversight

12. Managing Skilled Care-Oversight Don’t miss the boat on skilling residents for skilled nursing

13. Icd-10 • Effective 10/1/2015 services • Practice dual coding now!! • Invest in coding resources

15. Unscheduled Assessments

16. Early/late/missed assessments

17. Triple check

18. Communication is key

19. Medicare updates

20. Medicare update- SNF PPS FY 2016

21. Medicare update- SNF PPS FY 2016

22. Medicare update- snf quality reporting (QRP)

23. Medicare update- snf value based purchasing (VBP) program

24. Medicare update- staffing data collection

25. Medicare Update- staffing data collection • Requires SNFs to electronically submit direct care staffing information based on payroll data • Includes employees, agency and contract staff • Regular reporting schedule, no less frequently than quarterly • Voluntary 10/1/15, Mandatory 7/1/16

26. Medicare Update- ccjr demonstration model

27. Medicare Update- ccjr demonstration model • Areas selected in Missouri • St. Louis • Kansas City • Cape Girardeau • Columbia • Episode of Care • Hospitalization and all Part A and Part B services provided 90 days post-discharge

28. Medicare Update- ccjr demonstration model • SNFs will continue to bill and get paid by Medicare under current fee-for-service system • Hospital will ultimately be accountable for episodic costs exceeding targets • Includes waiver of 3-day hospital stay, beginning in second year of the program • However, waiver is only valid if beneficiary is transferred to a SNF with a 3-star or higher rating

29. Medicare Update- ccjr demonstration model • Ideal SNF Partners: • Good outcomes, lower cost • 3-star or higher quality rating

30. Medicare update- bad debt reduction

31. Medicare update- bad debt reduction • FYE 12/31/15 providers now at 65% for both duals and non-duals • Net bad debts also subject to 2% sequestration • Results in providers being reimbursed 63.7% (net) for allowable bad debts

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33. Thank you FOR MORE INFORMATION// For a complete list of our offices and subsidiaries, visit bkd.com or contact: Brian Hickman, CPA //Partnerbhickman@bkd.com //417.865.8701 Sherri Robbins, RN // Senior Managing Consultantslrobbins@bkd.com // 417.865.8701 Julie Bilyeu //Directorjbilyeu@bkd.com// 417.865.8701