Ensuring Safe and Reliable Transportation for SNF Residents
Explore policy reforms that hold HMOs accountable for providing reliable, safe transportation for skilled nursing facility residents, ensuring dignity and care continuity while reducing burdens on providers.
Advancing Outcomes-Based Reimbursement for SNFs
Outcomes-based reimbursement can replace outdated volume-based models, incentivizing innovation, improving resident care, and driving systemic excellence in skilled nursing facilities.
Enhancing HMO Participation in the Common Working File (CWF)
Mandating HMO participation in the Common Working File can reduce administrative burdens, improve claims accuracy, and ensure equitable standards across Medicare Advantage and traditional Medicare systems.
Aligning Reimbursement with Resident-Centered Care: Supporting In-House Dialysis in SNFs
Fair reimbursement, streamlined processes, and supportive policies can promote in-house dialysis in skilled nursing facilities, improving resident care while reducing systemic costs and inefficiencies.
Enhancing Dementia Reimbursement to Support Quality Care
Aligning reimbursement models with the true costs of dementia care can improve quality, sustain specialized units, and ensure residents receive the attention they deserve in skilled nursing facilities.
Deploy AI for Fraud Detection and Compliance Monitoring in CMS Programs
AI-driven analytics can transform CMS’s approach to fraud detection, improving program integrity, reducing financial losses, and ensuring Medicare and Medicaid resources are used ethically and effectively.
Automate Routine Claims Processing: Unlocking Efficiency in CMS Workflows
Robotic Process Automation can transform Medicare and Medicaid claims workflows, delivering faster reimbursements, reduced costs, and improved provider and beneficiary experiences through cutting-edge automation.
Fixing the Reimbursement Model for Secured Skilled Nursing Units
Equitable reimbursement for secured units in SNFs can sustain critical services, improve access for residents with dementia and behavioral health needs, and drive better outcomes for vulnerable populations.
Modernizing the CMS Nursing Home Survey Process through Risk-Based Surveys
A risk-based CMS survey process can improve resource allocation, prioritize resident safety, and address modern challenges like infection control and behavioral health, paving the way for more effective and efficient oversight.
Addressing the Gap in Medicare A Coverage for Non-Weight-Bearing Orthopedic Patients
A phased reimbursement approach can address gaps in Medicare Part A coverage for non-weight-bearing orthopedic patients, ensuring continuous therapy, better recovery outcomes, and financial sustainability for skilled nursing facilities.
Addressing the Broken Casemix HRD Calculation in Staffing Star Ratings
Reforms to the Casemix HRD adjustment methodology can improve staffing star ratings, align care with resident needs, and promote equity in nursing facilities, ultimately enhancing outcomes for high-acuity populations.
Incentivizing New Facility Development with Forward-Thinking 5-Star Rating
A Provisional 5-Star Rating Program for new nursing facilities can break down barriers, foster innovation, and drive investment in state-of-the-art care environments. This forward-thinking reform promotes fair competition and improved outcomes for residents, providers, and policymakers alike.