2017 The Reimbursement Revolution

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“The shot heard round the world” was the proverbial start of the American Revolution, the monumental political upheaval that led to the formation of our great country.  The healthcare industry is currently in the midst of its own unprecedented transition that will ultimately shape provider payment and operations for decades to come.

The Founding Fathers were visionaries, but they recognized the uncertainty our nascent society faced.  Nearly 250 years hence, the resolution of our healthcare revolution remains uncertain, abounding with unanswered questions:  What will become of the ACA’s innovation efforts such as Accountable Care Orgnizations and Bundling programs?  Will radical changes to Federal Medicaid funding formulas threaten our largest reimbursement source?  Will managed care continue to grow unabated despite its negative impact on providers?  Most importantly, how can skilled nursing facilities best position themselves in healthcare’s new world order?

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Program Overview

This two-day seminar will provide the skills required to lead your troops to victory in the Reimbursement Revolution.  The sessions are a “call to action” – a resounding rejoinder to Thomas Jefferson’s famous exclamation: “Do you want to know who you are?  Don’t ask. Act! Action will delineate and define you!”  SNFs must innovate as Healthcare Reform colonizes new frontiers and value-based payment becomes the “law of the land.”

Presenters

• Marc Zimmet, President, ZHSG
• Sheryl Rosenfield, Partner, Director of Clinical Services, ZHSG
• Michael Sciacca, Partner, Director of Operations, ZHSG
• Marie Infante, Healthcare Counselor at Law; Washington, DC
• Scott Rifkin, CEO, MidAtlantic Health Systems, RTMS

Special Notes

Zimmet Healthcare will not be providing seminar books. The program will be available on our APP for viewing/printing approximately one week in advance of the conference.

Borgata Hotel:   866-692-6742  Please make your sleeping room reservations directly with The Borgata.  A LIMITED BLOCK of rooms have been reserved under the Group Code GBZHS17.

Seminar Agenda

Day 1

• 8:00am – 9:00am — Registration  (Continental Bkfst provided)
• 9:00am – 10:30am — Reforming Healthcare Reform
  This session will provide an overview of Federal and State healthcare reform efforts instituted since passage of the Affordable Care Act, and analyze the impact of the new administration’s efforts to replace these initiatives.   SNF market trends and population demographics will be examined to assess how these changes will affect, and create value opportunities for, skilled nursing facility providers.
• 10:45am – 12:15pm — Reimbursement Update/SNF PPS Reform 
  The new  PPS is coming! The new PPS is coming! The new Medicate Part A PPS is “locked and loaded,” with implementation expected October 1, 2018 at the latest.  This is not a “refinement” as we’ve experienced in the past.  The new system adds significant complexity, with five distinct payment domains including a diagnosis-driven therapy component and length of stay-weighted per diem rates.  Mastering the system will require facility-wide changes in care management and documentation.  This program will provide early insight into the most significant payment reform in 20 years.  Presenters will also review new regulations specific to the MDS, SNF value-based purchasing, alternative payment models and reimbursement penalties.

• 12:15pm – 1:15pm — LUNCH
• 1:15pm – 2:45pm — Regulatory Update 
  This program will detail regulatory changes facing SNFs this year and beyond, with focus on implementation/ outcomes reporting relating to the SNF “Mega Rule” and Value-Based Payment initiatives.  The presenter will explore the resident-centered “chain of command” –  from admission to treatment to discharge, and the associated links to Requirements of Participation, post-discharge responsibilities and payment.  Comprehensive facility-wide implementation / integration strategies will be supported by innovative tolls and resources – all designed in context with national survey trends, outcomes, quality measures and re-hospitalization metrics.
• 3:00pm – 4:30pm — The Future of Long-Term Care 
• Healthcare Reform has compelled SNF operators to diligently measure and improve performance to enhance their value in the healthcare continuum.  It has also created perverse incentives for providers to sacrifice short-term gain for long-term positioning.  With an uncertain future, they only constant we face is change, but to what end?  A diverse panel of hospital system, ancillary provider, managed care and SNF operator representatives will share their vision of what the future holds for post-acute care.

Wine & Cheese with Exhibitors

Day 2

• • 8:00am – 9:00am — Registration  (Continental Bkfst provided)
  • 9:00am – 10:30am — Navigating Episodic Payment 
    The defining aspect of the US Constitution is that it can be changed to meet the needs of a developing democracy, just as SNF operations evolve to meet the changing needs of payers, patients and health systems.  Most notable among these developments is the emergence of “Eposidic Payment,” which presents the first comprehensive “risk-based” SNF payment structure.  The speakers will provide a primer on managing risk across all departments, from the business office to the rehab gym.  The session will also include a detailed “Data Roadmap” for constructing and presenting these programs to insurance companies.
  • 10:45am – 12:15pm — Applying Analytics to Risk-Based Payment Systems 
    This session will detail the strategic plan realized by one company and how management effectively integrated technology to reduce re-hospitalizations, improve reimbursement and gain market share.  Building upon the lessons of the previous session, the presenter will explain the advanced analytics used to establish (and profit from) an array of “risk-based” payment models.
  • 12:15pm – 1:15pm — LUNCH
  • 1:15pm – 4:30pm — Maintaining Compliance / Preparing for Battle
    Good government is predicated on a functional system of checks and balances; the same principle applies to healthcare compliance.  The past two years have introduced comprehensive operating changes to SNFs; concurrent to these challenges are new risk areas that operators must monitor.  Part One of this session will provide an in-depth review of clinical and financial compliance issues associated with the SNF “Mega Rule.”  Part Two will address the current Medicare audit/enforcement spectrum and offer strategies to ensure your facility survives any “sneak attack” that comes its way.