HCS, LLC Medicaid Case Mix Reimbursement

Healthcare Consulting Services, LLC (HCS), can provide Medicaid-certified nursing facilities with a wide range of services that will assist them in analyzing the reimbursement and operational impact of Medicaid Case Mix Reimbursement. By considering various strategic alternatives and establishing internal systems to improve both operational and financial performance, most facilities will be able to operate profitably under Medicaid Case Mix.

At HCS, we have found that many facilities do not have the necessary systems or resources to support:

	Capturing or tracking costs by resident or resident type
	Managing the MDS process and appropriate classification of residents
	Negotiating optimal contract terms with ancillary suppliers

	Managing the resident mix through admission policies
	Determining the staffing levels and mix

HCS staff have extensive financial, operational and regulatory experience in skilled nursing and hospital settings. We will review all aspects of a facility’s financial performance and clinical and billing operations that are impacted by the change to SNF PPS. Based on our analysis, we will suggest various scenarios and make specific recommendations about strategies and systems for managing under PPS. On request, we will assist in contract negotiations, coding and billing training, general PPS training and MDS and billing audits.

Often a PPS Preparation Review will identify other opportunities for improvement in operational and financial performance such as:

	Accounts receivable management
	Operational outsourcing
	Clinical pathways/protocols
	Restorative nursing programs

HCS’ staff is knowledgeable and skilled in assisting facilities in these areas. For more information about preparing for Medicare SNF PPS, call Pauline Clark at (317) 633-4708, Ext. 403 or e-mail at pclark@hcs-healthcare.com.

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