Reimbursement in geriatric healthcare is complicated and confusing. Additionally, the rules change frequently. Understanding how the care you provide and the way you document it effect your reimbursement is absolutely critical, yet many people just don't have the time or resources. Let me help you by analyzing your caseload.

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Medicaid Case-Mix Analysis

If you've ever considered a change in care (therapy, respiratory, restorative nursing) or a change in software (ADL, therapy) or a change in providers (therapy), then you've been faced with the question: "How is this change going to impact my case mix?" ALL vendors will tell you they will improve your case-mix which will in turn improve your reimbursement. 

Instead of hoping and guessing, a Monte Carlo simulation can approximate the change and give you confidence in what to expect.

  • Avoid surprised after the contract has already been signed.
  • Use the analysis as a negotiating tool
  • Make data-based decisions that are easy to defend.

Related Content: What's a CMI Point Worth?


Medicare Part A Analysis

Which is worth more, financially speaking: a 5% increase in the number of Medicare Part A patients in therapy or an average ADL increase of 1.5 points? When a therapy provider tells you they average 3% more patients in therapy than you currently run, does that offset the extra nickel per minute they want to charge?

These are easy questions for a Monte Carlo analysis to solve. See a probability distribution and understand the most likely scenario. Armed with information you'll be a better negotiator.

This type of analysis works for:

  • ADL Scores
  • Therapy
  • Respiratory
  • Restorative Nursing
  • Nearly every MDS item

Related Content: What's an ADL Point Worth?

LIkely CMI Increase for 1 or 2 ADL points

LIkely CMI Increase for 1 or 2 ADL points


Automatic range of motion measurements

Computer vision is an exciting emerging field that can help you get the outcomes you need to be successful. Imagine setting a flexion or extension target, a target number of repetitions and letting the patient drive the results. 

Giving patients goals helps them to take ownership of rehabilitation. Ownership of the rehab process is key to results and results matter in a world with bundled payments.


Medicare Part A Data ACQUISITION & Analysis

Does your organization lack the data it needs to compete? I have experience requesting, querying and analyzing both MEDPAR and CMS Limited Data (LDS) sets. Combine that data with other important databases:

  • Hospital Compare
  • Nursing Home Compare
  • Medicare Provider Utilization and Payment Data
  • OIG Exclusions

Additionally I have extensive experience using the Freedom of Information Act as well as various state open records laws to gain access to valuable data. Let me use those skills to help you understand your market.

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