With less than a month until the skilled nursing facility (SNF) Patient-Driven Payment Model (PDPM) takes effect, concerns about preparedness for this major payment change abound. Recent polls of HDG Learn webinar attendees indicate:
While the Centers for Medicare and Medicaid Services (CMS) provided 14 months to prepare for the new payment model, PDPM is a more complicated payment system than the RUG-IV model, and it relies on a broader array of disciplines for successful execution. Even though recommended as a best practice, it has turned out to be challenging for some SNFs to run parallel RUGs and PDPM models, slowing preparation further.
Under PDPM, clinical proficiencies will be paramount; nurses, as well as the whole interdisciplinary team (IDT), will have renewed concentration on critical thinking skills as the paradigm shifts to a more medically complex model. This will become the new normal.
Here are some key elements of the new normal that SNF managers and the IDT must ensure they focus on:
At this point in PDPM preparedness, skilled nursing providers should be able to:
HDG recommends the following action items to revamp your current practices for the new normal under PDPM:
Don’t forget that all Medicare patients will need an Interim Payment Assessment (IPA) if they will continue on a Medicare stay past September 30, 2019. PDPM is a “hard transition” on October 1—don’t make it harder by not preparing!
Health Dimensions Group offers comprehensive PDPM consulting solutions to assist you in preparing for this significant payment change, including on-site education, focused clinical and operational reviews, and financial benchmarking and projections, as well as live and recorded webinars. We can also help you make the pivot to medically complex care through service line development and market assessments. For more information, visit our website or contact us at 763.537.5700 or firstname.lastname@example.org.
Authored by: Katherine Davis, MS, CCM, CDMS, RCP, CRC, Manager, Consulting Services