Identify how you would overcome the challenge


Learning Objectives:

• Understanding what is included in the cost of care.
• Being able to define incentive-based (pay for performance) care.
• Recognizing the impact of Medicaid reimbursement on the quality of care.
• Explaining the Medicare reimbursement system.
• Differentiating Quality mix
• Patient Value


o An Evaluation of Performance Thresholds in Nursing Home Pay-for-Performance - Werner
o Explaining state nursing home reimbursement - Harrington
o How Medicare reimbursement works in skilled nursing facilities - Kander
o Incremental cost of post acute care in nursing homes - Spector
o Medicaid Capital Reimbursement Policy - Miller
o Payer source for single elderly women in nursing homes - Nakagawa
o The Cost of care - Candrian
o Impact of Nursing Home Pay for Performance ... - Grabowski


These assignments are due on Thursday July 2nd.

1. Write a 4 page (100 words) paper describing the overall reimbursement structure in the post acute world. Recognizing that the average SNF in New York loses between $20-$40 per patient per day for a Medicaid patient, include in the paper, an evaluation of the Medicaid reimbursement process and identify how you would overcome the challenge of caring for a population of Medicaid patients and still keep the facility operational.

2. Write no more than a 1 page (250 words) paper on whether a facility should consider a patient's payer source when deciding to accept or deny the patient for care.

The response should include a reference list. Double-space, using Times New Roman 12 pnt font, one-inch margins, and APA style of writing and citations.

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