Get the training and information you need to help improve Medicare reimbursements and financial operating results at your facility.
If you are one of the following healthcare leaders at your Critical Access Hospital, you should attend this boot camp:
- Revenue cycle and reimbursement professional
- Controller or member of the accounting staff (and others involved in the cost report compilation process)
- CEO, COO, Hospital Board member
Cost-based reimbursement can benefit Critical Access Hospitals, but only if you know how to appropriately operate under this reimbursement system.
This Boot Camp is designed to provide Critical Access Hospital (CAH) leaders with a macro- and micro-view of the Medicare CAH reimbursement system, commonly referred to as cost-based reimbursement. The class can also help hospitals obtain the appropriate Medicare cost-based reimbursement to which they are entitled under the Medicare program regulations and cost reporting instructions.
Medicare cost-based reimbursement affects the overall financial performance and strategic decision-making and planning of CAHs. A comprehensive understanding of cost-based reimbursement will allow hospital executives, Board members, and finance staff to develop effective, comprehensive financial and operations strategies.
The Core Sessions of this program provide a macro explanation of cost based reimbursement’s impact on CAH operations and finance, while the Advanced Sessions offer a detailed explanation of the Medicare Cost Report compilation process, forms, and underlying Medicare cost reporting instructions and regulatory requirements. Comprehensive reimbursement improvement strategies and cost report compliance issues are discussed throughout the program.
During the Core Sessions, we discuss Medicare Rural Health Clinics and provider based clinic designations due to their importance to health care delivery in rural America, reimbursement methodology, and related reimbursement implications to CAHs. The Core Sessions are completed with a discussion and reimbursement issues requiring C Suite attention to effectuate cost reimbursement strategies.
In this boot camp participants will learn how to:
- Understand the Medicare cost-based reimbursement system
- Recognize cost-based reimbursement improvements available to CAHs
- Identify how Medicare cost-based reimbursement affects their hospital’s financial decision-making and financial results
- Recognize the importance of each component of the Medicare cost report
- Complete a correct Medicare cost report
Core Sessions – September 25 & 26
- Introduction to the Medicare Critical Access Hospital program, its history, and CAH Medicare Conditions of Participation
- Basic principles of cost-based reimbursement. This session summarizes the Medicare cost apportionment formulary, overview of allowable and non-allowable costs, uniform pricing rule and Medicare utilization that drives Medicare cost-based reimbursement.
- How Medicare cost-based reimbursement affects your hospital’s financial decision-making and financial results
- How Medicare cost reimbursements increase or decrease with changing volumes, costs, payor mix, and product mix
- How Medicare cost reimbursements change when service lines are added or deleted and how to utilize this knowledge to make sound product line decisions.
- Hospital facility replacement and or major renovations: estimating amount of capital costs Medicare will reimburse and methods to increase capital costs reimbursement levels
- Overview of physician practice settings and reimbursement methodologies under the physician fee schedule reimbursement system, provider-based physician practices, and Medicare certified Rural Health Clinics and Federally Qualified Health Centers.
- Highlights the RHC Medicare conditions of participation requirements, covered services, and basic RHC billing.
- Explain the Medicare regulatory requirements for establishing provider-based physician practices, provider based RHCs and other provider-based type services such as Diagnostic Centers, therapy centers, urgent care centers, etc.
- Understand the reimbursement benefits and pitfalls of establishing either a Medicare certified Rural Health Clinic or a Provider Based Clinic.
- Identify compliance issues associated with provider-based clinics and other provider-based settings
- The relationship between report settlements, patient volume, and hospital Medicare contractual allowances and adjustments.
- We will finish this part of the program with general highlights of the cost report questionnaire and cost report compilation and filing process as well as the overall flow of the cost report for the non-accountant.
Advanced Sessions (Attending Core Sessions is a prerequisite) – September 27 & 28
- Review Medicare cost report forms and Medicare cost apportionment formulas within the forms. Major cost report worksheets will be discussed in detail, including compilation requirements and cost report worksheets specific to Medicare Rural Health Clinics. Attendees will comprehend the purpose of each worksheet within the cost report forms, data required to be compiled for each worksheet, and how the cost report “flows” to determine a hospitals Medicare program settlement amounts.
- Underlying cost reporting issues that affect reimbursements and final settlement, cost reporting strategies and reporting practices that yield appropriate Medicare reimbursements will be discussed and highlighted.
- Detailed cost reporting issues such as:
- Cost Report Questionnaire (now incorporated into cost report, previously a separate report CMS-339)
- Reporting requirement for patient statistics such as patient days and observation days.
- Medicare allowable cost principles, Medicare cost allocation methodology, and the Medicare cost apportionment process
- How to review the Medicare Cost Report for overall accuracy including the cost report settlement estimates
- Compilation and work paper compilation practices that will result in accurate and complete Medicare cost reimbursements
- Discussions on cost-based reimbursement issues such as:
- Physician compensation costs and allowable emergency department physician staffing costs
- Interest costs and other capital cost issues
- Other Medicare defined non-allowable costs
- Cost allocation and cost report strategies that yield appropriate hospital reimbursements by minimizing cost allocation to non-reimbursable cost centers and non-cost-based reimbursed services
- How hospital revenue reporting, charge structure, and Medicare revenues affect cost reimbursement and potential pricing strategies to minimize adverse Medicare reimbursement effects
- Note: Participants will receive a copy of QHR’s cost report review checklist and other relevant handouts to assist with annual cost report compilation process.
Need approval from your manager to register?
This letter template can help justify your trip and explain why it’s important that you attend. Customize to make it your own and send it to your supervisor.
- Core Sessions - Part 1
September 25, 2018
1:00 pm - 5:00 pm
- Core Sessions - Part 2
September 26, 2018
8:00 am - 12:00 pm
- Core Sessions - Part 3
September 26, 2018
1:00 pm - 5:00 pm
- Advanced Sessions - Part 1
September 27, 2018
8:00 am - 5:00 pm
- Advanced Sessions - Part 2
September 28, 2018
8:00 am - 12:00 pm
Venue: Quorum Conference Center
Venue Phone: 615-371-7979 or Toll-Free: 800-233-1470Address: