Clinical & Financial Medicare Reimbursement Updates

This session will explore key aspects of clinical audit and documentation requirements, including common findings and best practices. In addition, we will review the clinical submission process as it relates to the Skilled Nursing Facility Quality Reporting Program (SNF QRP) and the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP).

Participants will be presented with extensive financial benchmarking data derived from CMS Medicare claims and cost report data, including metrics on Case Mix Index (CMI), revenue, and expenses. The session will also feature regional benchmark data for Ohio and neighboring states, covering major Medicare initiatives such as CMS Five-Star Ratings, Payroll-Based Journal (PBJ), SNF QRP, and SNF VBP. These programs are critical in shaping future policy decisions and reimbursement structures at both the state and federal levels.

By integrating clinical trends with financial benchmarks, this session aims to equip attendees with actionable insights they can apply within their organizations. Attendees will gain both practical clinical recommendations and strategic perspectives to drive clinical and financial success now and into the future. The session will conclude with a data-driven analysis of current strengths and opportunities for improvement across the sector.