Risk Contracting - Go to http://www.lgcd.com/risk-contracting-its-the-new-game-in-town/ for the corresponding speakers notes.

1. RISK CONTRACTING
It’s the new game in town!
LGC+D LLP | 10 Weybosset Street, Suite 700, Providence, RI 02903 | 401-421-4800 | 401-421-0643 fax | www.lgcd.com

2. Be the Voice!

3. WHAT IS CHANGING?

4. HOW TO
SURVIVE AND
THRIVE?

5. VALUE PROPOSITION

6. WHY IS IT
IMPORTANT?

7. SELF-EVALUATE

8. WHAT IS RISK
CONTRACTING?

10. 0%
5%
10%
15%
Private Medicare Other Days Hospice Blue Cross Veterans Adm
13% 8% 5% 4% 2% 1%
Census Mix
Note: Medicaid portion of census mix is 67%
Data Source: LGC+D, LLP 2013 Rhode Island Nursing Home Cost Array

11. FINDING
SUFFICIENT
FUNDING

12. • Waiting on chart
CONSIDER AVERAGE
REIMBURSEMENT RATE RANGES

13. $203 - $811
$152 - $448
$264 - $291
$0
$100
$200
$300
$400
$500
$600
$700
$800
$900
Medicare 10/1/2014 Medicaid 10/1/2014* Semi-private Rate 2013
Rhode Island Revenue Per Day Ranges
*Excludes FRV and property taxes
Data Source: LGC+D, LLP 2013 Rhode Island Nursing Home Cost Array

14. CURRENT TRENDS

15. EVOLVING AND
FUTURE FOCUS

16. BUNDLED PAYMENTS AND
ACCOUNTABLE CARE ORGANIZATIONS

17. DRAMATIC CHANGES ANNOUNCED
BY MEDICARE – VALUE OVER VOLUME

18. HOW THE CHANGING
LANDSCAPE AFFECTS SUPPLY
AND DEMAND

19. HOW TO UNDERSTAND
AND EVALUATE RISK
AND PERFORMANCE

20. WHAT YOU NEED
TO KNOW

21. SYSTEM CHANGES –
WHAT DOES THIS
MEAN?

22. THE DEVIL IS IN THE DETAILS

23. New service providers are
building businesses around
publishing care protocols and
providing sophisticated IT tools

24. EVALUATIVE
REPORTS

29. WHAT ABOUT THE DATA?

30. Total Medicare
Medicaid /
Hospice
Private Other
Census 100.00% 8.21% 71.29% 12.50% 8.00%
Total CPD 353.27
PT 4615 MCR (6.14) 6.14
MCD (4.41) 4.41
Pvt (3.80) 3.80
MCD other (0.11) 0.11
ST/OT 4715 MCR (6.68) 6.68
MCD (7.92) 7.92
Pvt (2.11) 2.11
net w/o therapies 322.10
Average therapy CPD 12.82 12.33 5.91 0.11
Discrete therapy CPD, by payor 31.17 156.15 17.30 47.28 1.38
add non-therapy portion 322.10 322.10 322.10 322.10 322.10
Discrete cost by payor 353.27 478.25 339.40 369.38 323.48
Cost per Day – Therapy Discrete Cost

31. $322.10 $322.10 $322.10 $322.10 $322.10
$31.17
$156.15
$17.30
$47.28
$1.38
$0
$100
$200
$300
$400
$500
$600
Total Medicare Medicaid / Hospice Private Other
Cost per Day – Therapy Discrete Cost
Non-Therapy Portion Therapy Discrete Cost
Overall Cost
$353.27
Discrete Cost
$478.25
Discrete Cost
$339.40
Discrete Cost
$369.38
Discrete Cost
$323.48
Data Source: LGC+D, LLP 2013 Rhode Island Nursing Home Cost Array

32. DISCRETE COST ANALYSIS

33. IMPACT ON CONTRACT DISCUSSIONS
AND RENEWALS

34. Questions?
Visit our blog for this PowerPoint and my notes!
http://www.lgcd.com/category/cpa-for-everyday/
Pamela L. Sawin, CPA, Principal | psawin@lgcd.com
LGC+D LLP | 10 Weybosset Street, Suite 700, Providence, RI 02903 | 401-421-4800 | 401-421-0643 fax | www.lgcd.com