How Will PDPM Affect My SNF?
Arete Rehab has always focused on patient outcomes and never on minutes. So, our practice model doesn’t change—will yours?
In our current RUG-IV system, the number of therapy minutes delivered is the primary factor that determines payment. In this system, the problem has long been that providers may focus on the amount of therapy rather than the quality. Of course, there are measures built in to address this, but ultimately, therapy is paid by the minute and the rate per minute can be the same no matter how long the patient has been receiving treatment. With RCS-1 and PDPM, the reimbursement methodology shifts away from minutes to focusing on patient characteristics and incentivizes outcomes. In PDPM therapy rates decline after 20 days at 2 percent every seven days.
While some may view this change as encouraging less therapy, Arete Rehab sees this shift as one that supports patient-centered therapy that relies on getting patients back to their highest level of function quicker. Outcomes will be more important than ever! At Arete Rehab, we empower our therapists to determine the appropriate level of care through realistic productivity requirements for each patient.
PDPM outlines some more flexible new service delivery options for patients and therapy providers. Group and concurrent therapy is something that can be considered and utilized at a capped rate of 25 percent per discipline with at least 75 percent of therapy being individualized, which improves outcomes and drives down costs. Putting this decision in the hands of therapists is a step toward helping increase patient outcomes while driving down costs. Arete Rehab is also continuing to expand offerings across the continuum of care. Who doesn’t want to get home quicker when recovering from illness and injury? Historically, some of the biggest barriers to transitioning care settings is losing some of the therapy gains made in the SNF, but with consistency in therapy providers, this impact can be mitigated. Therapy via outpatient and home health will play an even bigger role in maintaining outcomes.
ASSESSMENTS & PATIENT CLASSIFICATION:
Currently, MDS assessments can be viewed as a burdensome and frustrating part of care delivery, with 5, 14, 30, 60 and 90-day scheduled assessments and five more potential unscheduled assessments, providers can end up feeling like it is all they do. In PDPM an initial five-day and final discharge scheduled assessment is proposed along with an optional interim payment assessment. While the requirement is markedly less, the importance of them is not. Functional assessments will be particularly important under PDPM as they help define the starting point for patients and therefore impact both outcomes and payment. PDPM has adopted Section GG for functional assessments for both therapy and nursing components.
“P” IS FOR PATIENT:
While we are still a way away from implementation, and the Final Rule has not yet been published, one thing is clear, October 2019 will be here before we know it and PDPM will dramatically impact our day-to-day business and service delivery. Under PDPM therapy providers will need to manage better than ever how services are delivered to ensure we are providing patient-centered care for our patients and ensuring the therapy provided achieves the greatest possible outcomes. So, when it comes down to it, the most important letter in our alphabet stew is the one that represents the patient.
Therapist owned and therapy-driven, Arete Rehab is a nationally recognized leader in contract rehabilitation services. We We empower our therapists to determine the appropriate level of care through realistic productivity requirements for each patient. As partners, we are stronger together.