The transition to the patient driven payment model (PDPM) over the last two years has not been without its challenges. COVID-19 shifted SNFs’ priorities away from the PDPM transition during year one to an all-hands-on deck approach to prevent the spread of the virus.
Year two continued to bring fresh challenges, including the ongoing pandemic response and an administration change that impacted nursing facility operations and the way care is delivered.
What have we learned from the national data since the implementation of PDPM? What can we learn by looking back, and what do we need to be successful on the road ahead?
What do you know about PDPM so far?
- Did you know the Patient-Driven Patient Model (PDPM) increased payments to SNF’s in Year 1 by $1.7 billion when it was expected to be budget neutral?
- Do you know how CMS is monitoring the PDPM data?
- Are you confident that your data tells CMS the right story about PDPM?
[psst! I’ll be answering these questions at the 2021 AHCA/NCAL Convention & Expo. Will I see you there? Learn more. ]
Transforming Tomorrow with the Right PDPM Tools
Since the beginning of PDPM in 2019, PDPM Insights has been used by 2000+ SNFs, including large, multi-state chains and smaller regional and local providers. Customers value the application for enabling accurate capture of PDPM reimbursement and limiting compliance risk.
PDPM Insights enables proactive management of PDPM reimbursement by resident, facility, and corporation, through up-to-date MDS analytics. SNFs can access case-mix, per diem, and revenue analytics for Medicare Part A and Medicare Advantage stays, before locking the MDS, so they can correct errors, ensure accurate reimbursement, and track projected revenue.
PointRight’s existing PDPM Insights product is being enhanced with a new Revenue Analysis tab to analyze total revenue trends, and additional analytics for length of stay (LOS) and discharge destination.
PDPM Revenue Analysis Highlights
- Revenue analyses calculated daily with the most current MDS submissions: Enables proactive review of each MDS’ estimated revenue, payment days, and case mix drivers without having to wait for month end
- Payment days and estimated total revenue by skilled resident, with flags for imputed stays: Helps to identify missing MDSs potentially impacting LOS and revenue calculations
- Length of stay metrics organized by discharge destination: Supports operational performance analysis and business development.
Resources: eBook: PDPM Rate Driver Data 2020