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PAMA skilled nursing timeline

After 2018 CMS will move forward with PAMA regulations with Penalties/Bonuses

  • Skilled Nursing Facilities (SNF) with the highest rankings receive the highest incentive payments and Skilled Nursing Facilities (SNF) with a zero or low ranking will receive the lowest incentive payments
  • Effectively, the lowest 40 percent of Skilled Nursing Facilities (SNF) will be reimbursed less than they otherwise would in the absence of this program
  • To fund the payment pool, CMS will withhold 2% of Skilled Nursing Facility (SNF) Medicare payments starting October 1, 2018. CMS will then redistribute 50-70% of the withhold back into to Skilled Nursing Facilities (SNF) by way of incentive payments
  • CMS will keep the balance, 30-50% as savings to Medicare

The Substantial Financial Cost of PAMA Penalties

The Skilled Nursing Facility (SNF) 30-Day All Cause Readmission measure is potentially very costly to Skilled Nursing Facilities (SNF).

The financial penalties from CMS will likely be similar to those faced by acute care hospitals with higher than average 30-day readmission rates: up to 3% of Medicare reimbursements. The SNF data will be risk-adjusted. (Details about the risk adjustment calculation will likely be released in early 2018.)

At least some patients will be excluded from the measure, including:

  • Residents who are transferred to an inpatient rehabilitation facility
  • Residents who are transferred to a long-term acute-care facility
  • Residents who are discharged directly to home
  • Planned readmissions that happen within the 30-day period
  • Residents who leave the Skilled Nursing Facility (SNF) against medical advice
  • Patients with specific DRGs (principally cancer and cancer-related diagnoses)
  • Patients who are readmitted for observation only. Information Sourced from
  • HealthStream.com Post Dated February 24, 2016
  • “There is evidence that virtual encounters can reduce the number of ED visits. That saves money for payers and can also enhance the bottom line of healthcare organizations that are at risk for the cost of care,” says Joseph Kvedar, MD, vice president of connected health at Partners Healthcare in Boston, in Medical Economics
  • 93% of consumers using TeleMedicine reported a lower healthcare cost–Becker’s Review

With the TeleHospitalist on call, protocols in place, and cart integrated into your EMR, you’ll feel like you have the physician in house—but at a substantial savings.

Calculate Your Cost Savings With TeleHealth Solution.

Visit The Cost Savings Calculator
Visit our cost savings calculator online

PAMA: Protecting Access To Medicare Act

Next Upcoming Change is October 1st, 2018: Medicare reimbursement rates for Skilled Nursing Facilities (SNF) will be based partially on their performance scores beginning on October 1, 2018


Reduce Readmissions

Readmissions are costly, put patients at risk for complications, and 80% of them are preventable.


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Post Acute Care

In the event a patient requires transfer to the ED, our TeleHospitalist will provide direct communication to the ER physician.

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Marketing Advantages

A Marketing Edge & Advantage! The peace of mind brought to families and patients by 24/7 physician access is priceless.

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End-of-Life Care

The hardest conversation to have with a patient or their family at Skilled Nursing Facilities (SNF) are about end-of-life care.

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EMR Integration

TeleHospitalists can instantly review labs, enter orders, document, and managing the patient by accessing your EMR

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Our TeleMedicine Technology

Our TeleMedicine Device is Compact, Advanced and powered by one of the largest hospitalist networks in the country.  Examine and consult with patients in the clinical setting or remotely with the FDA Approved IDM100. No other device on the market compares to its technologic advancements

  • The cyber-secure IDM100 captures, stores, and manages cardiopulmonary and vital signs data.
  • 3- & 12-lead ECG
  • Electronic stethoscope
  • Suntech™ NIBP with MAP and pulse rate
  • Covidien Genius 2™ Tympanic Thermometer
  • NellCor Oximax™ SpO2 with respiratory rate
  • Hearing test with interpreted audiogram
  • 2 internal HD cameras for medical images and video
  • Patient management using Care Central (patient data software with alerts, trending, EMR sync, and Virtual Exam Room)
  • Spirometry with interpretation for lung evaluation
Our Technology
Our TeleMedicine Technology is Compact, Advanced and powered by one of the largest hospitalist networks in the country

Contact our Business Development Team today and learn more
about our TeleMedicine Solution. Call 833.633.3497