PDPM Reimbursement Analysis: November 2019 Claims
Performance Considerations in the Context of Healthcare Reform.
CORE’s client base has grown considerably in both size and diversity since we released our October analysis. Adding November claims from providers in new markets highlights differences in performance driven by the uneven distribution of “national” Healthcare Reform initiatives.
Early PDPM Claims Data Revealed!
October findings were both fascinating and comparatively confounding relative to the RUG-system. Every Component array raised questions and displayed coding inconsistencies.
National Revenue and Quality Benchmarks (CY 2018 Update)
CORE recently scanned the CY 2018 claims file to identify national trends on SNF length of stay and discharge disposition by clinical category, with the results displayed above. These figures, although interesting, do not come close to telling the complete story. Healthcare is a local business, and outcomes vary significantly in different markets.
Understanding the SNF Data Profile
Author: Vincent Fedele
Since the onset of the national “healthcare reform” movement, industry pundits have used historical SNF data to explain variations in post-acute episodic spend and outcomes, often applying questionable “case-mix adjustment” factors to improve performance optics.
Zimmet Healthcare Launches Analytics Platform
“CORE” Redefines Skilled Nursing Facility Claims-Based Intelligence
Morganville, New Jersey – October 3, 2018 – SNF reimbursement is rapidly transitioning from a fee-for-service system to a value-based, managed model that presents significant financial risk to providers. This “race to the top” requires data-driven outcomes to quantify a provider’s value-proposition in the healthcare continuum.