Patient Driven Payment Model

70th AHCA/NCAL Convention and Expo

PDPM-1 - Managing Care After the Five-Day Assessment

Speaker(s)

• 

  Nate Ovenden, RAC-CT

  Senior Medicare & Managed Care Consultant
  Good Samaritan Society

  Disclosure: Nothing to Disclose

The new Medicare SNF PPS patient driven payment model (PDPM) is based on resident characteristics reported on SNF PPS minimum data set assessments. While the five-day assessment is critical to establish the baseline resident classification for the SNF stay, CMS introduced three new policies that can affect payment rates at different points of the stay, including the interim payment assessment, the interrupted stay policy, and the variable-per-diem rate policy. This session will describe these new policies and possible strategies providers can take in implementing them during a resident’s Part A stay.

Learning Objectives:

• Describe the key features of the PDPM IPA, Interrupted Stay, and Variable Per-Diem policies.
• Apply recommended strategies to implement an effective internal IPA policy.
• Apply recommended strategies to implement an effective internal interrupted stay management process.
• Apply recommended strategies to effectively manage care under the variable per-diem policy.