Cheat Sheets and Timely Visits: How SNFs Can Support Doctors’ Larger PDPM Role

May 3, 2019

Timely physician visits will play a central role in effectively capturing resident conditions — and reimbursements — under the new Medicare payment model. But with doctors seeing relatively few incentive changes amid the shift to the Patient-Driven Payment Model (PDPM), skilled nursing operators must find ways to make physician collaboration as easy as possible.

Medical directors and other physicians who work in skilled nursing facilities will become vital resources for accurate ICD-10 coding and Minimum Data Set (MDS) reporting, Rajeev Kumar wrote in a recent piece in Caring for the Ages, a journal published by AMDA — The Society for Post-Acute and Long-Term Care Medicine.

“ICD-10 coding education, training, and support for MDS clinicians falls on medical directors and all clinicians in the facility,” Kumar, chief medical officer for rehab and pharmacy provider Symbria, wrote. “External resources such as coding experts from professional associations and regional hospitals might be a great help as well.”

Under PDPM, set to take effect October 1, Medicare reimbursements for skilled nursing providers will be more closely tied to resident conditions — in general, operators will receive higher reimbursements for patients with more complex medical problems and co-morbidities.