70th AHCA/NCAL Convention and Expo
At the time of this program, skilled nursing providers will have had less than two weeks experience with the new Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) called the Patient-Driven Payment Model (PDPM). PDPM is the most significant payment model change since the transition from cost-based reimbursement to the Resource Utilization Groups (RUG) based PPS payment model in 1998. The Centers for Medicare and Medicaid Services (CMS) priorities with PDPM are two-fold: a) better align payment with resident care needs as reflected by clinical characteristics; and b) make quality and value-based programs the key measures of provider PDPM performance.
In this 3-hour session, attendees will hear from, and have the opportunity to ask questions of, the former CMS Center for Medicare Director of the Chronic Care Policy Group Laurence Wilson. In his former role, Mr. Wilson oversaw all SNF and other Medicare-financed post-acute care fee-for-service benefit and payment policy. In this capacity, he directed all phases of the CMS PDPM research, payment model design, and regulatory processes from inception until earlier this year. He will share insights regarding CMS’ motivation to change post-acute care payment models, the process of developing the PDPM and possible future iterations of PDPM, and the long-term future of SNF payment policy.
Since CMS finalized their plans to implement the PDPM on October 1, 2019 over a year ago, providers engaged in preparing their clinical and financial operations to successfully transition to the PDPM. During this interactive session, attendees will hear from a panel of SNF operators who will share their experiences in preparing for PDPM implementation over the past year or more. They will discuss why they feel they made a successful transition to PDPM. Specifically, the panel will highlight successes, best practices, and, also, will discuss lessons-learned from strategies that were not as successful as envisioned. Additionally, the panel will discuss how they are monitoring IMPACT Act Quality Reporting Program (QRP) measures which CMS is using as the primary PDPM monitoring tool. Finally, the panel will offer insights on how they see PDPM evolving in the coming years.