A growing number of SNFs or skilled nursing facilities across the US are facing revenue-related challenges. It has become difficult for them to survive in business, considering the number of industry changes taking place. For instance, some facilities are under financial pressure because they are operating on thin margins in the face of insufficient Medicaid reimbursements. Private-pay population numbers have also declined which has caused financial problems for many facilities.
There are various other problems being faced by skilled nursing facilities. The need for inpatient skilled nursing care has decreased as several new programs are allowing Medicaid funded services at home as well as in communities. Also, the number of residents required for skilled nursing is reducing at a rate of 1% per year. Some facilities are struggling with inadequacy of nurse staffing while others are dealing with penalties for being unable to prevent hospital readmissions.
With the launch of Skilled Nursing Facility Value-Based Payment Program (SNFVBP) in 2018, reimbursement penalties will go into effect in 2019. Once implemented, providers of skilled nursing facilities will have to account for not only exact services offered to the patients but also the actual quality of care. Providers who will show the best readmission rankings will receive high incentives whereas providers with poor rankings will get low incentives from the payment pool managed by the CMS (Center for Medicare & Medicaid Services). So in order to avoid leaving money on the table, it will become necessary for skilled nursing facilities to work on good readmission rankings.
To ensure the fiscal health of a skilled nursing facility, it is necessary to keep on top of eligibility verification. At times, skilled nursing facilities experience lost or delayed revenue because of the complications related to checking eligibility status. Another challenge is related to the conversion of outstanding revenue into cash. For this, sound revenue cycle management is very important. Providers need the right experience and expertise to focus on billing and accounts receivable management practices. They need the right expertise in project management, business process analysis and systems auditing.
Contracting with a billing company is the best solution for SNFs who are struggling with implementation of effective revenue cycle management. By hiring a reliable medical billing company, SNFs can not only get paid on time for rendered services but also reduce accounts receivables, lower costs and comply with healthcare regulations.