CMS Cut to PDMP & RFP Process Benefits

by | May 12, 2022 | HR Legislation

According to Skilled Nursing News, on April 11 CMS unveiled a 4.6% cut to the Patient-Driven Payment Model (PDPM) and 3.9% increase to Medicare payments for skilled nursing facilities (SNF). The PDPM cut will create a total loss of approximately $320 million in Medicare funding, according to CMS. For skilled nursing facilities that are already struggling due to the impact from the pandemic and staffing issues across the country, this possible cut could prove disastrous.

As SNFs prepare for the impending effects of the proposed cuts this is a great time to take a 360-degree assessment of the facility to find creative ways to save without lowering employee benefits and offerings. Premier Workforce Solutions specializes in creative business solutions that save employers without compromising employee offerings. We have a scalable healthcare solution that has averaged a 35% savings on health insurance spend for SNFs while decreasing deductibles and premiums on the plans for employees. The remaining savings can be used to absorb the upcoming CMS cuts and to help alleviate staffing issues through improved employee compensation and organizational culture. This is just one of many solutions we can offer. Premier Workforce Solutions specializes in custom solutions built to help organizations grow and overcome obstacles to accomplish their mission.

The RFP Process

Securing an RFP for health insurance can seem like a cumbersome process as employers are securing two RFPs typically: one between the company and potential broker(s) and one between the selected broker and potential carriers. The RFP process itself can be broken down into a few basic steps:

 

1. Employer looking for insurance issues an RFP to find a broker.
2. Brokers respond to the RFP and the company selects a broker.
3. Selected broker writes and issues an RFP to various carriers to find the best value for company.
4. Broker evaluates the carrier proposals, compares offers and recommends carrier.
5. Employer makes their carrier selection and signs a contract.

What are the benefits to the RFP process?

While the RFP process may appear simple choosing a healthcare provider is a complicated task with many details to consider. Comparing and evaluating providers background, coverage, services, and cyber security is simplified with an RFP as it allows you to quickly access the items that matter to you most and compare apples to apples across providers.

Employers issuing RFPs for insurance services benefit from the competitive nature of the process. Brokers and insurance companies know their proposal will be compared side-by-side with others and will typically make their best offer the first time. This leads to faster contracts and getting the new plan in place.

 

Insurance brokerages can provide a wealth of services above and beyond consulting on insurance purchases. An RFP helps to explore and compare each broker’s additional services. For example, firms may have risk management information services, underwriting & analytical services, HR consulting, wellness options and more. During the RFP process, companies can easily verify that each prospective broker has experience navigating relevant regulations and policies. This allows you to make sure you are selecting the best broker for your industry. It’s a good idea to evaluate the current broker you are partnered with and make sure you are still with the best fit the current state of your company and your future growth goals. Employers should have a strong relationship with their broker and a broker should be evaluating and advising the employer on a regular basis. Brokers that show up once a year at renewal time are not doing their job. Benefits change every year and often increase in cost. Remember, just like everything else your benefits should have an ROI for your business. If you think it’s time to evaluate your broker, Premier Workforce Solutions has a Broker evaluation & RFP review services to make it easier on your team. We can help identify if you are receiving the right level of service at the best cost. If an RFP is recommended, we can manage that process as well. Learn more about our services and our experienced team of professionals here:
https://premierworkforcesolutionsllc.com/a dvisory-services/