Session 8 | To IPA or Not IPA: A Very Important Question
Day: Monday, August 1 Time: 10:00 to 11:30 a.m. Type/Topic: Finance and Reimbursement
Session Summary
The Patient Driven Payment Model (PDPM) improves payment for complex residents by providing payment for five case mix adjusted components. The complexity of the payment system makes it less clear what the final payment will be for a specific Medicare A resident. This confusion leads to missed opportunities to improve reimbursement with an Interim Payment Assessment (IPA). This session will help identify and focus on the components with the greatest opportunity for payment improvement. Speakers will explore the Health Insurance Prospective Payment System (HIPPS) code and how to understand the present payment so that opportunities are obvious. The entire Medicare team will benefit from this session and will learn which resident treatments and services to listen for during daily and weekly meetings.
Presenters
Carol Maher
Director of Education | Hansen Hunter & Co.
About the Presenter
Carol Maher is a Board certified Gerontological RN with over 30 years of long term care experience. She has worked as an MDS coordinator for large skilled nursing centers and as director of clinical reimbursement and senior vice president of utilization for large skilled nursing facility companies. Carol has worked as one of the Gold Standard nurses for MDS 3.0, serving on the RAP workgroup to prepare the way for the CAAs for MDS 3.0, and participating on a number of technical expert panels related to MDS, Quality Measures and care planning. She is also a frequent author of articles related to the RAI process and PPS. Carol served as a member of the AANAC Board of Directors for nine years. She is presently serving as the immediate past chair of the AANAC Expert Advisory Panel and as an AANAC Master Teacher of the RAC-CT and RAC-CTA certification courses. Carol is the Director of Education for Hansen Hunter & Co.