Harmony Healthcare Blog

AHCA Provider Lounge Series: Mark Parkinson - AHCA

Posted by Kris Mastrangelo on Fri, Jan 03, 2020

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


Interview with Mark Parkinson, President and CEO of American Health Care Association (AHCA)

Kris Mastrangelo, President and CEO at Harmony Healthcare International (HHI), interviews Mark Parkinson, President and CEO of the American Health Care Association, in the AHCA Provider Lounge.   Mark discusses his views on PDPM, Five-Star and state Medicaid rates.  He says he, like most of the industry, is cautiously optimistic about PDPM as it brings focus back to nursing and restorative care.  He also shares his concerns about the current state of the Five-Star rating.  He would like to see CMS incorporate patient satisfaction into Five-Star.  Additionally, Mark and his team at AHCA have been working to help increase Medicaid to states that meet certain criteria.

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Topics: Medicaid, Five-Star, PDPM, Mark Parkinson

2017 AHCA Provider Lounge Series: State of Medicaid in the State of New Jersey

Posted by Kris Mastrangelo on Fri, Jan 05, 2018

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Interview with Loretta Kaes, Director of Quality Improvement and Clinical Services of the Health Care Association of New Jersey Health Care

Kris Mastrangelo, President of Harmony Healthcare International (HHI) interviews Loretta Kaes, Director of Quality Improvement and Clinical Services of the Health Care Association of New Jersey Health Care (HCANJ), in the 2017 AHCA Provider Lounge.  Loretta discusses the impact recent regulatory changes, along with ACOs, have had on reimbursement, in particular Medicaid reimbursement, in the state of New Jersey.  (Audio transcription below).

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Topics: Medicaid

Accountable Care Organizations Update:  ACOs and Medicaid

Posted by Melissa Fox on Wed, Nov 23, 2016

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Across the country, states are exploring the viability of Medicaid Accountable Care Organizations that align the provider and payer incentive to focus on value instead of volume.  The Center for Medicare and Medicaid Services is currently aligning partnerships in order to identify a collaborative approach to providing better care at an efficient cost.  During the harmony16 LTPAC Symposium, Harmony Healthcare International (HHI) presented on the upcoming changes to CMS initiatives with Medicaid Beneficiaries.  The following topics were discussed:

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Topics: ACOs, Medicaid, Accountable Care Organizations

New York Medicaid Case Mix: 14 Tips for Accurate Reimbursement

Posted by Kris Mastrangelo on Fri, May 13, 2016

Understanding the criteria and components of RUG Leveling (53 levels) and Categorization is imperative for accurate and appropriate reimbursement under the New York Case Mix reimbursement system. Protocols and defined processes are essential for success and require implementation throughout the year, (not just during the case mix "window").  Ongoing MDS coding oversight and refinements are even more important given the regulatory and reimbursement changes impacting quality measures and the ultimate crescendo of value based purchasing. The following tips may help you in preparing your documentation to properly reflect all necessary data to support the appropriate payment level.

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Topics: Medicaid, Case Mix, New York State

Medicare and Medicaid Proposed Rule:  Regulatory Changes for Long-Term Care Facilities

Posted by Joyce Sadewicz on Thu, Nov 19, 2015


On July 13, 2015, the Centers for Medicare and Medicaid Services published a Proposed Rule that revises the requirements for participation in Medicare and Medicaid programs for long-term care facilities. This CMS proposal is due to the fact that as CMS states, “The population of nursing homes has changed, and has become more diverse and more clinically complex.” Evidenced based research has been conducted that has provided greater knowledge about resident safety, health outcomes, individual choice and quality assurance and performance improvement. Major changes have not been made to the conditions for participation since 1991 despite the significant changes to service delivery in this setting.

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Topics: Medicare, Medicaid, proposed rule

Intergovernmental Transfers: Funding State Medicaid Programs

Posted by Kris Mastrangelo on Tue, Jul 14, 2015

Intergovernmental transfers (IGTs) are a transfer of funds from another government entity (e.g., county, city or another state agency) to the state Medicaid agency. The ability of a state to use IGTs to fund their Medicaid program is recognized in statute (§1903(w)(6) of the Social Security Act) and rule (42 CFR §433.51).  Medicaid has been a joint financing partnership between the states and the federal government since 1965. This provides a guarantee of federal matching funds for state expenditures for health and long-term care services for the country’s low-income population.
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Topics: Medicaid, IGT, Intergovernmental Transfers

New York State Transitions to Medicaid Managed Care Plan March 1st

Posted by Kris Mastrangelo on Tue, Mar 04, 2014

Effective March 1, 2014, all eligible beneficiaries over the age of 21 in New York City, Nassau, Suffolk and Westchester counties, in need of long term placement in a nursing facility, will be required to join a Medicaid Managed Care Plan (MMCP) or a Managed Long Term Care Plan (MLTCP).  The rest of New York State is scheduled to begin transitioning this coming September for both dual and non-dual eligible populations and all upstate counties will be phased in by December 2014.

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Topics: Medicaid, Medicaid Reimbursement, Managed Care

Case Mix as a Medicaid Reimbursement System

Posted by The Harmony Team on Wed, Jun 20, 2012

Case Mix - Medicare Minute

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Topics: Medicare, Medicaid, Case Mix, OBRA, MDS, PPS, MDS assessment, Medicaid Reimbursement

Harmony Healthcare Launching Therachirps Blog!

Posted by The Harmony Team on Wed, Jan 11, 2012

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Topics: Medicare, Therapy, Medicaid, Reimbursement, LTC

Revenue Isulation, Documentation and RUG-IV

Posted by The Harmony Team on Thu, Jul 14, 2011

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Topics: Medicare, MDS 3.0, Medicaid, RUG-IV;

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