From Manual Reimbursement Audits to Proactive, Continuous Intelligence
For decades, skilled nursing leaders operated in a reactive cycle. MDS teams submitted assessments, operators waited for the billing cycle to close, and only then could they see whether they had hit their reimbursement marks. By that point, it was too late to intervene.
Adam Cusner, CEO at Lionstone, remembers this cycle clearly, “Pre-MedaSync, we would have to wait until the cycle is complete to really get an understanding of reimbursement issues in our facility. But now we’re able to showcase a predictive element and identify where we need to give more support before things close.”
The Cost of Looking Backward
Reactive reporting meant surprises at the end of every cycle. A mis-coded MDS, an overlooked comorbidity, or a function score fluctuation might quietly erode reimbursement opportunity without anyone noticing until the books were closed or the team had time to complete a manual audit.
MedaSync’s Proactive Power
With MedaSync, leaders see real-time insights across their portfolios. The platform not only captures reimbursement opportunities but also models their impact on both CMI and QIP. A coding decision that boosts reimbursement but risks a QIP penalty can be weighed instantly, with two clicks.
Chelsea Lowe, VP of Clinical Reimbursement described the breakthrough, “Before MedaSync, we had an okay handle on QIP. But what MedaSync did was it allows us to quickly see if by capturing this for CMI causes anything to trigger for QIP. You’re able to do that with two clicks of a button versus reading through all the nurses’ notes.”
Why Predictive Matters
- Fewer surprises: MedaSync eliminates end-of-cycle guesswork.
- Smarter trade-offs: Operators evaluate QIP vs. CMI instantly.
- Proactive focus: Leaders can direct resources to struggling centers.
Predictive analytics isn’t just a buzzword. With tools like MedaSync, it’s a practical, daily advantage that turns reimbursement from reactive auditing into proactive strategy.
See how MedaSync’s predictive approach has helped Lionstone turn reimbursement complexity into revenue clarity.
