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SNF Contract Rehab. Rates

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We provide contract rehab services to a SNF. I am curious if there is any trend

in rates charged to facilities going up or down for part A and managed care

patients.

Thanks for any input

Kristie Leverenz, PT

Mark Leverenz, OTR/L

United Therapy Services, Inc.

7411 112th St

Blue Grass, IA 52726

kmlev@...

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Kristie

There are some interesting conversations going on between contract therapy

companies and skilled nursing facilities. The cost of delivering therapy

services is increasing so contract therapy companies are asking to increase the

rates they charge an SNF. The payment to SNF for Medicare A PPS RUG rates is

overall being reduced by 14%. Add to this the MPPR discounting that has

implemented on Medicare B rates. So facilities are asking for a proportional

rate reduction from their therapy providers.

It's important to note that the 14% reduction being quoted is not what a

specific facility will experience. Each RUG rate is not being reduced by 14%.

Some are being reduced as much as 18% while other RUG rates are actually

increasing by 4%. The RUG categories an SNF is likely to use will determine what

their experience will be moving forward. We provide our customers with a RUG

calculation tool where they insert the number of days they billed each RUG in

fiscal year 2011 and it will calculate what they would have received for FY 2012

rates and compares the difference. This is a better predictor of what they are

likely to experience.

A difficult argument for contract therapy companies is that the RUG rates with

the greatest decreases are the Rehab RUG. Facilities are likely to point this

out in any contract negotiation. There is a counter argument to this. Many

contract providers base their rate on a percentage of the " Therapy Component " of

each Rehab RUG. While the overall RUG rate has been reduced you will find that

the Therapy Component of those RUG rates has increased 2 - 3%. It is also

important to note that the reduction in 2012 rates is a reaction to the

inadvertant increase of 2011. Those rates resulted in 17% higher payments to SNF

than 2010 even though the prediction was that they would be budget neutral. This

means that overall SNF are 3% better than 2010. I doubt that any passed on the

17% increase they received last year.

I hope this has answered some of your questions. Feel free to contact me

directly if you would like clarification on what I have written or have other

questions.

Ron Wall

Axiom Healthcare Group

Ontario, CA

To: PTManager

From: leverenzm@...

Date: Sun, 30 Oct 2011 00:32:20 +0000

Subject: SNF Contract Rehab. Rates

We provide contract rehab services to a SNF. I am curious if there is any trend

in rates charged to facilities going up or down for part A and managed care

patients.

Thanks for any input

Kristie Leverenz, PT

Mark Leverenz, OTR/L

United Therapy Services, Inc.

7411 112th St

Blue Grass, IA 52726

kmlev@...

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