As each fiscal year approaches, changes are made by the Centers for Medicare and Medicaid Services. These changes can sometimes be surprising and can make for some amazing differences, even though it might take a lot of work for those changes to take place. Back in 2018, it was decided that, effective October 2019, there would be a case-mix model to determine payment. They state that this payment model is a patient-driven one which will better suit patients based on their condition rather than the amount of care that went into caring for them. This means it’s shifting from volume to value which, in so many words, means CMS is calling for a unified post-acute care payment system.
One of the biggest struggles when it comes to medical care workers is all the paperwork they can get caught up in. We’ve all seen the charges and each little thing has to be accounted for and charged to a patient’s account. One of the biggest focuses of the changes taking effect in October is reducing the mounds of paperwork involved with patient care. This will dramatically reduce the administrative burden currently being observed.
The overall focus of these changes, and perhaps the crowning jewel of the proposal is that these changes will walk away from focusing on the volume of care provided to patients. Instead, the focus will be on the value of care needed for a patient concerning their condition. This means the focus will be on the unique needs of a patient. Overall, this is a safeguard against patients receiving care they might not need in connection with their condition and the focus will be placed more on their actual medical needs and less on the volume of the care they can be subjected to. To put it simply, these changes are meant to drive medical personnel into offering valuable care rather than piling on as much as they can for a payout, resulting in volume of care and not always value in care.
Although it would be beneficial to see these changes happen sooner, there is quite a bit of training and adjustments that will have to be made in order for the switch over to happen smoothly. Further, the new training will involve a new method in reporting so that caregivers have more of an opportunity to connect with their patients in hopes that this focus on valuable care can be extended even more in the process. It’s important to point out that stakeholders pushed for a simpler payment system with the largest focus being on the patient and the care they’re provided. With a simpler payment system, caretakers are can be less involved with reporting and paperwork and more involved with patient care.
CMS has left it open for further discussion with stakeholders if and when changes might be needed in the future. Once implemented, there may need to be some slight adjustments to ensure the system is doing what it was designed to do.