The recent CY 2021 Physician Fee Schedule Update introduced a variety of billing and reimbursement changes aimed at reducing complexity and addressing the COVID-19 crisis. And while this update offsets some of the Final Rule fee schedule cuts, the result sees many providers still facing revenue shortfalls.1
For therapy companies providing services to skilled nursing facilities (SNFs), the operational outcome is a mixed bag. Although CMS recently increased reimbursement for assessments and evaluations carried out by therapists, the new 2021 rule also brought a 10 percent decrease to the relative value units (RVU) conversion factor for E/M services.2 In practice, this means an overall reduction of approximately 3 percent to therapy revenue this year, even after Consolidated Appropriations Act recalculations are applied.3
To succeed in 2021, SNF therapy leadership must offset potential losses by maximizing operational efficiency.
Here are three ways SNFs can improve outcomes without sacrificing consistency or quality of care:
1. Solve for SNF Staffing Issues With Improved Scheduling
As noted by the Health Affairs Journal, Medicare’s recent adoption of the Patient Driven Payment Model (PDPM) has led to a significant reduction in therapy staffing levels as the financial incentive to provide volume-driven services was removed.4 These issues have been further exacerbated by the reduced RVU conversion factor, in turn making it more difficult for therapy companies to drive revenue with current staffing supply.
And while there’s no quick fix for PDPM or Fee Schedule complexity, it is possible for SNF therapy providers to maximize efficiency with agile scheduling software capable of matching the right patients with the right therapists at the right time.
2. Streamline Service and Billing Processes With Compliant Software
Delays in reimbursement caused by cumbersome billing processes pose significant risks for therapy companies already struggling after 2020. As noted by the American Physical Therapy Association (APTA), 72 percent of therapy businesses saw revenue losses of 50 percent or more last year.5 This means that if invoices are stalled — or rejected — as a result of missing information around differing payer plans or specific modifiers, SNFs may find themselves struggling to keep the doors open and the lights on.
Precise and compliant billing processes are paramount to ensure invoices are paid promptly and in full. By deploying solutions that allow therapy leaders to easily configure individual payer plans, support different contracted rates and generate per-payer reports, it’s possible for SNFs to reduce the amount of time spent managing invoice-based tasks without impacting revenue streams.
3. Support Fee Structures With Data-Driven Insights
Fee negotiations remain critical for therapy provider success, but with both SNFs and payers also facing revenue challenges thanks to the pandemic, it’s more difficult than ever to ensure fee structures remain stable — let alone making sure they aren’t rolled back.
Here, data-driven insight is critical to support fee structures. With easy access to therapy data using role-based dashboards, SNFs can quickly break down results by therapist, patient and location to clearly articulate the impact and outcome of therapy services under PDPM.
With the therapy services landscape in SNFs rapidly changing in response to both the 2021 fee schedule and the evolving COVID crisis, companies need every advantage they can get when it comes to maximizing operational efficiency. Find out how Net Health® Therapy for Skilled Nursing Facilities can help.
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1 CMS, “Physician Fee Schedule,” February 24, 2021.
2 CMS, “Final Rule CMS-1734-P,” December 28, 2020.
3 JD Supra, “New Year Brings Significant Changes to Medicare Physician Fee Schedule,” January 5, 2021.
4 Health Affairs, “Medicare’s New Patient Driven Payment Model Resulted In Reductions In Therapy Staffing In Skilled Nursing Facilities,” March 2021.
5 APTA, “Impact of COVID-19 on the Physical Therapy Profession,” August 2020.