Patient Driven Payment Model (PDPM): Financial Moving Parts

This fifth session on our series will discuss the components of PDPM and how they contribute to the overall payment rate. We will dig into the Variable Adjustment Factor for the PT/OT and NTA components, and show examples of how the per diem rate changes over the length of the Medicare stay. In addition, we will discuss the Interim Payment Assessment (IPA) and Interrupted Stay Policy: two aspects of PDPM that may significantly affect reimbursement. Facility policy and care coordination processes play a role in ensuring PDPM success; we will outline opportunities for improvement and strategies for facilitating these changes in your organization.

PDPM Learning Objectives (Recording Timestamps):

• Describe the aspects of PDPM that affect per diem rates and overall reimbursement (5:45)
• Understand the potential impact of variable reimbursement on facility budget planning and resource allocation (40:50)
• Apply strategies for getting systems in place to mitigate financial and compliance risk (46:00)

Presenters:

• Jennifer Gross, BSN, RN-BC, RAC-CT, CPHIMS, Senior Healthcare Specialist, PointRight
• Paola DiNatale, MSN, RN, NHA, Senior Healthcare Specialist, PointRight

NOTE: CEU credits are provided for live sessions only. On-demand, recorded sessions are provided for educational benefit and do not offer CEU certification.

PointRight Free PDPM Education Series

• Session 1: PDPM – The Basics
• Session 2: Non Therapy Ancillaries (NTA) – Understanding the Facts 
• Session 3: ICD-10 Codes and the Drivers of PDPM
• Session 4: Understanding the Section GG ADL Function Scores 
• Session 5: PDPM: Financial Moving Parts (You Are Here)
• Session 6: The Phase 3 Requirements of Participation and PDPM – Are You Ready?
• Session 7: PDPM: The Home Stretch