Solutions for Owners & Providers

Pay for Performance: from pay for treatment to pay for outcome

If nursing homes bill Medicare up to 100 days of coverage per condition, facilities will have to provide restorative care to get paid by Medicaid and then will have to prove that they provide restorative care to get Medicaid to pay.

The attitude of the provider will change immediately if payment is for outcome versus their income. Providers will have to perform in pursuit of results based on documented preprogrammed outcomes. At the same time, they will be forced to conserve resources that they are currently wasting so they can deliver what the buyer is going to pay for and for the price they will receive.

Transmittal 262

By understanding Transmittal 262 and seeking help to manage the complexities of Medicare, skilled nursing facilities can increase business, control cost and quality, and generate thousands of additional dollars of revenue.