◂  November 2018

Patient-Driven Payment Model (PDPM): An in-depth program on the most significant change to Medicare reimbursement in over 20 years.

Published by: pattyadmin


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Patient-Driven Payment Model (PDPM)
Preparation is Key:  An in-depth program on the most significant change to Medicare reimbursement in over 20 years

CMS finalized plans to move from the Prospective Payment System in place since 1998 to a patient characteristics-based payment system, known as Patient-Driven Payment Model (PDPM), effective October 1, 2019. This represents the most significant change in Medicare reimbursement methodology in over 20 years and providers need to begin to prepare now in order to be successful under the new system. While CMS has calibrated the new model to be budget neutral across all providers, individual facilities could see dramatic changes in their annual Medicare revenue as a result of the new system. There are many strategic and operational decisions and changes that should be made prior to the October 1, 2019 implementation date if you want to be ready.

Detailed description of the new model

  • What are the five rate components?
  • What grouper methodology will be used for each component?
  • How does the rate tapering work?
  • What assessments will be required?

Resident specific case studies

  • How will the rates under PDPM compare to PPS rates for the same resident?

Operational considerations to help providers be more successful under the new model

  • How should the team evaluate potential admissions and predict payment rates?
  • How should the role of the MDS nurse change?
  • How should care pathways change?
  • How will the billing process need to change?

CEU’s:  5 – Administrators and Social Workers

Cost:   HFAM Members – $165 first person, $140 each additional
Non- HFAM Members – $225 first person, $200 each additional

View Brochure for additional program and registration information

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