LeadingAge New York Adviser Adviser LeadingAge NewYork Spring 2019 final | Page 27

LeadingAge New York
Reimbursement Update
On Wed., May 22, 2019, in front of an audience of about 60 LeadingAge New York provider, associate and
business members, speaker Darius Kirstein provided updates on the constantly evolving reimbursement
of New York State long term care providers. The session was relevant to members of all long term care
service lines. Business leaders seek certainty for financial projections and budgeting, while nursing home
reimbursement remains fluid. As an industry expert, Kirstein was able to offer clarity in the very important
but fluctuating world of reimbursement. Kirstein presented in a format that was useful for executives
looking for strategies for building for the future. Attendees concerned with daily operations were
also given valuable information that will be useful in making budgetary decisions. The learning
opportunity was specifically valuable to CEOs, administrators, CFOs and CPAs.
The session was appropriately titled LeadingAge New York Reimbursement Update
because there were many issues worthy of updates. Session attendees were given
crucial new information about the reimbursement landscape, Managed Long Term
Care (MLTC) changes, community-based service line highlights and Medicaid
and Medicare reimbursement issues. Although the presentation was conducted in a
large room, it was clear that the audience was welcome to participate. The atmosphere
in the room was collaborative in contrast to the lecturing environment of a traditional
presentation. During the discussion, an issue that received significant attention from both
Kirstein and attendees was Medicaid case mix changes. Kirstein dedicated significant time to helping
listeners understand the current landscape surrounding case mix. He offered guidance on the expected
changes to case mix based on his knowledge as a member of the recently developed case mix workgroup.
Those in attendance were also made aware of important discussions with the Department of Health (DOH),
providing context to some recent DOH decision-making in managed care. The session speaker continued by
offering information on budget cuts that were avoided and prior year cuts that are not being implemented.
Additionally, members were informed of important grant opportunities that they may not have previously been
aware of.
Kirstein further detailed 10 important Medicaid funding issues that gave stakeholders reimbursement
insights to bring back to their organizations. Those interested in Medicare reimbursement-specific
topics learned about strategies to avoid financial penalties, areas that are likely to generate
greater audit scrutiny and possible Patient-Driven Payment Model (PDPM) changes.
Individuals that attended the educational session were engaged and received valuable
new reimbursement updates. They learned about important new funding
opportunities, risk areas and upcoming deadlines. The LeadingAge New York
Reimbursement Update presentation was especially valuable while so many
reimbursement issues remain under scrutiny and likely to change.
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