PDPM affects your facility by ensuring that you provide comprehensive patient care over volume. While past models categorized patients into a single, volume-driven group, PDPM ensures facilities focus on providing unique services to meet each patient's needs, goals and characteristics. 

Comprehensive care can include therapy, nursing and non-therapy ancillaries. The model lends itself to potentially more complex, specific case mixes. As a result, PDPM may also affect your health center by keeping it fiscally healthy and dedicated to providing the best possible care for patients. 

So how does PDPM work, and what individual components does it affect within your facility?  

• Care management: Unlike past models that incentivize high volumes of therapy to maximize payments, PDPM requires that facilities manage how they deliver services to provide the correct level of care for each patient. Each resident will have their own classification, ensuring that SNFs aren't paid for providing services beyond these individual levels. Under-delivering therapy, however, can lead to poor patient outcomes, potential Medicare audits and take-backs.
• Financial: PDMP offsets therapy reimbursement losses with higher reimbursement for nursing care already provided. From an economic perspective, contract PDPM therapy providers may have seen a reduction in revenue. However, they may achieve neutral positive profit margins due to PDPM provisions. 
• Staffing: Lastly, PDPM affects your facility by changing therapy and nursing demands. With a focus on high quality, value based care, the more physician expertise you have, the better the result. 

Overall, the patient-driven payment model redefines the relationship between payment and quality characteristics, realigning payment and quality incentives for PDPM therapy services within your health center.