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Confidence GainedSenior Living &

Long-term care and senior living experts

Whether you’re a retirement community and/or assisted living facility, skilled nursing facility, or specialized housing facility, BerryDunn can help you optimize finances, staffing, processes, and technology. Our expert advisors deliver practical, up-to-date advice for improving each client’s performance. We design our assurance services to not only meet audit, review, and/or compilation financial statement requirements, but also to provide value-added insight on operational and reimbursement opportunities.

Our client engagements are led by CPAs, business consultants, and IT professionals specifically focused on supporting healthcare service providers. Clients work directly with senior talent who take the time to understand local markets, unique challenges, and client-defined goals and objectives. We also provide proprietary benchmarking data to provide clear, relevant performance comparisons to and among regional peers, which clearly highlights both strengths and opportunities for improvement. We then leverage what we’ve learned to develop clear, actionable strategies—and make better-informed operational and financial decisions.

Working with more than four decades of experience, our team of expert business, finance, operations, and technology advisors have tackled challenging issues for a broad range of healthcare clients, making us uniquely suited to help clients in their efforts to address:

  • Complex reporting and regulatory requirements
  • Sluggish revenue cycles and slow collections
  • Inefficient processes
  • Cloudy projections
  • Daunting financial statement reporting requirements
  • Outdated or under-utilized technology
  • Complex reimbursement regulations
  • High taxes and low cash flow
  • Turnover in key leadership roles
  • Retrospective settlements
  • Confusing Affordable Care Act notices or penalties
  • Under-trained billing and compliance staff
  • Rapid industry consolidation

Related Professionals

CMS calculation revision for VBP program adjustment
Effective for Medicare payments for dates of services 10/01/2019 – 9/30/2020

During the CMS SNF VBP Program Performance Score Report Teleconference on Tuesday, August 27, 2019, CMS notified providers of a potential error in calculating their FY2020 value-based purchasing adjustment. CMS estimated 14% of providers’ reports had errors in calculation of their readmission rate—86% of providers were not affected. Revised files are now available through the CASPER reporting system.

Why is this important?

Providers need to understand their federal Medicare rate structure, and build reimbursement (per diem rates and contractual adjustments) tables prior to billing claims for dates of service after 10/1/19. CMS reported 72% of SNFs had Incentive Payment Modifier (IPM)<1, earning a net negative incentive adjustment (rate reduction). The VBP IPM applies to all SNF inpatient claims covered by Medicare as of October 1, 2019. 

What should you do?

  1. Log in to the CASPER reporting system and identify your performance score report marked as “corrected”.
  2. Review the facility-specific data by 9/26/19. Contact the SNF VBP Help Desk with any questions or data correction requests. Note: If a provider report shows “dashes” instead of numbers, the provider is a low utilization provider with 25 or less Medicare discharges in a year, and the IPM is 1 (exempt from VBP adjustment).
  3. Correct your facility’s per diem rates (if applicable) in your billing and reimbursement tables prior to generating claims for dates of services after 10/1/19.
  4. If CMS recalculated your adjustment, you may need to understand the impact of this adjustment on your budget and revenue projections.

Other VBP adjustment application notes:

  • VBP adjustment (IPM) is not-patient-specific, and does not apply to individual MDS/assessments.
  • VBP adjustment (IPM) only applies to SNF Medicare A (inpatient) claims.
  • IPM applies to the federal per diem rate similarly to sequestration, as an adjustment to the overall Medicare payment to providers (not a part of claim submission).
CMS calculation revision
Value-Based Purchasing (VBP) program adjustment

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