News & Events

Facilities Thriving Under Current Model Poised to Take Biggest Hits Under PDPM


by Maggie  Flynn, Skilled Nursing News

As skilled nursing providers prepare for a new Medicare reimbursement system, those with solid revenues under the current model may be in for the most severe declines going forward.

Operators that have mastered the current Resource Utilization Group (RUG) system tend to be those projected to see reimbursement declines under the new Patient-Driven Payment Model, according to an analysis by Plante Moran — while the so-called PDPM “winners” generally have lower RUG hauls.

It’s a reality that the advisory and consulting firm expressed bluntly in a webinar presentation earlier this week.

“Providers who are projected to do well under the RUG system are not projected to do well under PDPM,” Denise Gadomski, health care consulting partner at Plante Moran, said.