2019 SNF Medicare Reimbursement Outlook

February 6, 2019

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In 2018, CMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. By replacing RUGS (Resource Utilization Groups), PDPM represents the most significant Medicare Part A SNF payment policy change in more than two decades. In a changing healthcare landscape it is important for medical product distributors and manufacturers understand how their customers will be paid by Medicare. This webinar will provide an overview of the potential impacts PDPM will have on SNFs by covering:

  • PDPM basics and new per-diem components
  • Interactions with IMPACT Act QRP’s (Quality Reporting Programs)
  • Interactions with SNF VBP (Value Based Purchasing)

Presenters


Caroline Haarmann, MPH
Associate Vice President of Medicaid Reimbursement & Research
American Health Care Association (AHCA)


Caroline Haarmann is the Associate Vice President of Medicaid Reimbursement & Research for the American Health Care Association (AHCA), responsible for the association’s Medicaid portfolio of work. In addition, she chairs the Partnership for Medicaid’s policy committee, leading that coalition’s policy content development. Ms. Haarmann began her work in health care at a PPO network in Atlanta, Georgia, where she conducted in-depth qualitative and quantitative research and analysis of trends, legislation, and regulations in the healthcare industry, including Medicaid and Medicare. Ms. Haarmann holds a Master of Public Health degree from Columbia University’s Mailman School of Public Health and a Bachelor of Arts degree from Bryn Mawr College.


Katherine Almendinger, MS
Director of Research
American Health Care Association (AHCA)

Katherine Almendinger is a Director of Research at the American Health Care Association in Washington, DC. She supports AHCA’s members on their journey to quality improvement as they navigate policy, legislative, and regulatory oversight changes. Her work also advances long-term and post-acute care research, informs AHCA’s legislative efforts, and helps guide conversations with CMS on how these changes impact the sector. Prior to joining the AHCA team, Katherine worked at the Research Data Assistance Center (ResDAC), where she served as an MDS topic expert and helped researchers access and use CMS data. Her other work has been primarily in clinical research. Katherine is currently working toward earning her DrPH in health policy and management at Johns Hopkins University with a specialization in quality and patient safety. She received her MS in epidemiology from Harvard University and her BS in chemistry and molecular biology from the University of Minnesota.