PDPM Webinar: How Clinicians Can Shine in New Payment Model
MEMBERS ONLY CONTENT
The Patient Driven Payment Model (PDPM) will take effect on October 1. This not only represents a major change in how skilled nursing facilities (SNFs) are reimbursed; it also will significantly impact the dynamic between clinicians and the facilities they service.
If you’re not ready for PDPM it’s time to gear up. The Society is here to help with a webinar, PDPM: An Opportunity for PALTC Clinicians. Set for April 18 from 6:00-7:30 PM ET, the program will focus on the regulatory details of the new model and provide guidance on how practitioners can optimize their relationships with their facilities as PDPM moves forward.
“For the first time in a long time, physicians have the ability to weigh in on the level of medical complexity for patients and be critical members of the operations team in their facilities. They will be able to devise treatment plans and therapy protocols to promote the best, most person-centered outcomes,” says Steven Buslovich, MD, one of the webinar presenters. “Everyone is paying attention to this, and we need to create new collaborations with facility leadership to ensure their buildings remain viable.”
Under PDPM, instead of therapy hours providers will receive Medicare payments based on the complexity of patients’ care needs. “Medical directors and other practitioners aren’t directly impacted by the reimbursement under PDPM, but they will play a more critical role in their facilities in terms of providing accurate diagnoses and coding,” says Dr. Buslovich. “We will talk about the difference between what is required under PDPM and what practitioners are used to under the current reimbursement system. Under PDPM, they will have to establish a diagnosis that details why the patient is in the facility.”
PDPM is designed to improve payment accuracy and appropriateness by focusing on the patient, rather than the volume of services provided. It also will significantly reduce administrative burdens on providers and improve SNF payments to currently underserved Medicare beneficiaries.
Rajeev Kumar, MD, FACP, CMD, another webinar presenter, says that at the Society’s recent annual conference he was surprised how many practitioners weren’t familiar with PDPM. “Practitioners should be aware of PDPM, and many aren’t. It doesn’t affect clinicians directly, and we have so many other issues and regulatory changes to deal with that PDPM isn’t on everyone’s radar. But it should be,” Dr. Kumar says. “We ought to be a tremendous resource for our facilities and help them by being good stewards of PDPM in terms of what is appropriate and beneficial. This is where good clinicians can shine. We can choose to be more engaged and involved and be of immense help to our facilities.” This webinar, Dr. Kumar notes, will guide those just getting started to the right path and help those who are further along by providing them with the tools and resources to succeed.
To sort through all of the resources and information about PDPM would be a daunting task, Dr. Buslovich observes. “We are still learning so much about the process and the impact of PDPM. You need to know everything possible about this model, and you need to know it now. We have done the research for you and will present it in a practical stepwise way. You wouldn’t take your boards without preparing. This is no different.”