The Patient Driven Payment Model (PDPM) is the CMS Medicare value based payment model set to...

The Patient Driven Payment Model (PDPM) is the CMS Medicare value based payment model set to go into effect in October 2019. How will it impact facility staffing patterns and resident reimbursement/billing?

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Expert Solution

Some of the ways it will impact staffing pattern and resident reimbursement are

The addition of section GG needs further analysis and evaluation because of time consumption
Renaming it to RCS2 from RCS1 may make more confusions among healthcare workers
It would reimburse SNF Based on the component of care delivered by provider, nurses,physical therapy, occupational therapy and non ancillary therapy
Case mix Medicare reimbursement for SMF alterations and changes to be done
Reduction in total therapy minutes has decreased the demand for therapist and forcing to select more qualified professionals
Care offered to the patients shoukd be specific over providing will not provide extra reimbursement or under service may take back reimbursement.

Nightingale answered 2 years ago

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