MedaSync Helps SNFs Achieve Financial and Operational Success
Managed care penetration is growing, but along with that comes growing pains. More than one-third of all Medicare patients are now under one form of a managed care plan or another, and with an aging population, that number is expected to continue climbing as 66 percent of people newly eligible for Medicare are choosing Medicare Advantage. This poses a significant financial and operational risk to SNFs whose staff must now navigate the ins and outs of numerous Medicare Advantage plans — each with its own complex set of request procedures, requirements, and guidelines — in order to be reimbursed.
While the Patient-Driven Payment Model (PDPM) will soon change the system for traditional Medicare cases, with an expected growth of 12 percent throughout 2019, the challenge posed by managed care will persist and even grow. With level-based plans, more services are being provided without being captured and thus aren’t properly billed. Case management teams face greater administrative burdens with prior authorizations and recertifications that create workflow inefficiency. Service costs continue to mount as acuity rises. And a lack of uniquely blended clinical, financial, and insurance performance data means SNFs are making decisions in the dark.
MedaSync is the first centralized case management system that helps SNFs address each of these challenges. Our software monitors care and services, instantly flags anomalies, and alerts teams to reimbursement opportunities that are typically missed. With intelligent, actionable data, SNFs can improve their operational efficiency and workflow, reduce costs and advocate for additional services, and use data to improve decision-making.
Benefits of Using MedaSync in Your Building
Missing out on revenue that’s buried in managed care contracts? Is a lack of coordination between case management and billing leading to lost opportunities? MedaSync automates the charge capture process across the board, bridging the gap between these groups and ensuring correct billing for care provided. Information from more than 500 patient data points is pulled from your EHRs, contracts, and more — all without any duplicate entry. Contractual obligations are monitored, alerts are sent for potential level changes, and carve-outs are flagged so all exceptions are properly billed.
Precertification and recertification take time, and all the while, patients need care. MedaSync eases the administrative burden of these complex, required steps. MedaSync integrates with your existing systems to aggregate everything — from medications to treatments and progress notes — all in a single, centralized location. Automated workflows help coordinate tasks and communication so nothing is missed — saving your SNF from having to hire while also providing immense scalability. And with a single login across your entire enterprise, everyone has access to the information they need.
With MedaSync, improving revenue through service capture is only half of the benefit to financial and leadership teams. MedaSync also helps SNFs proactively plan and manage utilization costs pre-admission and throughout the entirety of a patient stay — allowing teams to understand expected costs, identify opportunities for savings, analyze the care patients received, and pinpoint areas for improvement. Alerts are sent when a cost threshold is reached, empowering team members to advocate for billing level changes or alternatives as clinically appropriate.
While MedaSync helps your front-end clinical and operations teams work more efficiently and deliver even better patient care, the benefits don’t stay at the ground level. SNF leadership teams need to be able to understand past business performance and make decisions for the future. MedaSync provides in-depth analytics that operators need to do just that. Put your historical and real-time data to use to better understand cost and revenue drivers, identify potential issues, and drill down into business data by diagnosis, payer, and other criteria.