“By adopting a platform now, they can assure all systems are in place and run test submissions to assure they're in good shape prior to the deadline,” said Jim Hoey, president of Prime Care Technologies.

In this month’s BI-focused blog postings, we explored the process of decision making, PBJ compliance reporting automation, using BI to help providers beneficially get the attention of ACOs, and, along that same line, establishing and strengthening relationships with key referral sources.

Data-driven decisions – an art and a science?

With the right information, you, the provider, can make the right decisions, right now! But even if the information is right, timely, relevant, and rendered actionable, making “the right decision” is a skill. But is decision making an art or a science? And what role does BI play? Read on.

It’s about time - Providers should automate PBJ reporting

Like it or not, Payroll-based Journal reporting is just around the corner and will become a routine requirement for all SNF providers. And it comes with a kick in CY 2017 – a Five Star Rating kick. How can automation expedite the monitoring and reporting process? Find out.

How Business Intelligence can help execs stand out in an ACO crowd

In our recent blogs, we’ve highlighted how Business Intelligence (BI) can help providers more effectively tell their stories to stakeholders, investors, and referral sources. However, providers have another key audience to whom they could effectively present data-driven demonstrations of value and quality – ACOs. Learn more.

Business Intelligence can help demonstrate value to referral sources

As the reimbursement world changes from fee-for-service to pay-for-performance models, demonstrating value is key. To be able to effectively demonstrate value compliant with payment model expectations, providers need to be able to know how well their facilities are performing today. The technology needed to effectively identify and communicate such value is available through BI. Discover how.

Are you able to make the right decisions with the right intel when you need it?

PBJ is just around the corner. So, what is it and what does it mean for you?

PBJ, or Payroll Based Journal describes what CMS requires you to submit online, effective 3Q 2016 and due 45 days after the quarter ends – that’s November 14.  From there, it will become a routine requirement for all SNF providers. And it comes with a kick in 2017 – a Five Star Rating kick. You are probably familiar with PBJ, but let’s net out the essentials so you can understand and act with some urgency. 

Background: With the passing of “The Improving Medicare Post-Acute Care Transformation Act,” or IMPACT Act, providers must submit “payroll and other verifiable and auditable data” electronically to the Department of Health and Human Services. It’s objective? Improve transparency and reduce potentially fraudulent reporting. You can check out the tedious details on the CMS and Federal Register websites:

• FAQs: Electronic Staffing Data Submission Payroll-Based Journal System
• Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs) for FY 2016, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and Staffing Data Collection

The Change: In short, PBJ is the CMS’s latest push to keep providers honest when reporting labor hours and census – and eventually, will critically impact your 5 Star Rating.

• Every quarter, providers must use the online PBJ system provided by CMS to report the hours staff – AND contractors – were paid to perform onsite services for facility residents, excluding paid time off (e.g., vacation, sick leave, etc.).
• The PBJ system will only allow XML file submission – one per facility – and/or manual data entry at this time.
• CMS started collecting staffing and census data through the PBJ system on a voluntary basis beginning on October 1, 2015.
• Submission will be mandatory, effective July 1, 2016. Providers will be required to file both staffing and census data no later than 45 days after the last day of each fiscal quarter (i.e. for the quarter ended September 30, 2016 electronic reporting must be completed no later than 11:59 pm EST on November 14, 2016).

Don’t be lulled by the November 14 3^rd quarter reporting deadline. Collecting this data and preparing it for submission will take time – lots of time (and money) – especially if you are trying to do this manually.

There is a way to make this PBJ requirement easier to swallow. We proactively added a PBJ tab to our primeVIEW business intelligence dashboard to help our clients. New clients can also purchase this component on a stand-alone basis to meet the CMS mandate.

Our PBJ Reporting Platform empowers providers to:

• Integrate cross-facility data from employee and census systems
• Manually enter and append contractor data to existing file
• View/monitor a summary of employee and contractor hours
• Automate mapping of labor codes to CMS codes
• Export one all-inclusive XML file per facility for quarterly upload

With staffing and census playing a key role in the CMS’s Five Star rating and compliance, providers can’t afford to waste critical time building reports and checking data. An already-built solution quite simply frees up your time, so you can focus on proactive performance management.

The first mandatory reporting period, starting July, will be here before you know it. The time to act is now. 

And, if PBJ is the first major step you’ll take to aggregate all of the performance data you need to affect your Five-Star Quality Rating, check out our business intelligence blog.