Patient-Driven Payment Model (PDPM)

 

What is PDPM?

PDPM is the proposed skilled nursing facility (SNF) payment system designed to promote value-based care by shifting incentives from the volume of services a patient receives to a system where payments are based on the patient’s condition and care needs. A CMS fact sheet on the final rule, effective October 1, 2019, provides more details on this new case-mix model and incentive changes.

PointRight is Here to Help You Every Step of the Way

Join PointRight’s team of Senior Health Care specialists in a series of education webinars that will help you understand what PDPM is, what it isn’t and how you can prepare your organization to support PDPM implementation. You can sign up for our live webinars below or sign up to get alerts for the full series as the webinar dates are published. You can also view a video of PointRight’s Chief Clinical Officer Steve Littlehale previewing upcoming PDPM changes.

PDPM Education Series: Featured Session

Patient-Driven Payment Model (PDPM):
Understanding the Section GG ADL Function Scores (Session 4)

View Recording & Handouts

This webinar is the fourth in our educational series providing insight and information on the new Centers for Medicare and Medicaid Services (CMS) Patient Driven Payment Model (PDPM) that will go into effect October 1, 2019. This session will discuss the impact of Activities of Daily Living (ADL) functional scoring on the Therapy and Nursing components of PDPM.  We will review examples of Minimum Data Set (MDS) coding for specific areas of ADL function, and discuss the differences between coding ADLs in MDS Sections G and GG. We will outline strategies for interdisciplinary team collaboration in capturing the full picture of a resident’s usual ADL function, with ideas for best practice.

Learning Objectives:

  • Outline the details of the Patient Driven Payment Model (PDPM) components that are impacted by Activities of Daily Living (ADL) functional scores.
  • Identify Minimum Data Set (MDS) items used to calculate the resident’s Therapy and Nursing functional scores.
  • Apply strategies to develop systems for timely and accurate ADL scoring

View Recording & Handouts

How to Prepare for PDPM – Steps to Take Today

 

  • Look for those diagnoses that you use the most, and work from there to practice capturing the most specific ICD-10 codes possible.
  • Make sure diagnoses that often get buried in the checklist in Section I are brought out and coded in I8000 to capture the NTA.
  • Work with your physicians and physician extenders to make sure that they are documenting the specific diagnoses to get the right ICD-10 codes.
  • Communicate with your interdisciplinary team and ask: Why is the resident here? If you can answer that question with the right diagnosis, you can be confident of PDPM success.

PDPM Education Sessions:

Video Insights: Patient-Driven Payment Model (PDPM)

In this 12-minute video, Chief Clinical Officer Steven Littlehale explains PDPM and the implications for the industry.

Sign up for PDPM Education Series alerts!

If you’d like to receive an invitation to each of our PDPM educational webinars, sign up for alerts. Let our experts at PointRight keep you in the loop with everything PDPM.