Advantages of the PDPM Reimbursement Model
The PDPM reimbursement model has many advantages for centers and patients, from helping improve payment accuracy to ensuring appropriate treatment by focusing on each patient rather than the volume of services provided. It also reduces the administrative burden for providers and enhances SNF payments without increasing overall Medicare payments.
Here's a breakdown of the benefits of the PDPM medicare system:
1. Enhances Patient Care and Management
One of the most significant benefits of PDPM medicare is that it emphasizes patient-centered care. Under previous models, facilities were encouraged to over-deliver therapy services to receive more funding. Rather than focusing on providing a specific volume of therapy services to calculate reimbursements, the new model ensures facilities are only reimbursed according to each resident's case mix classification.
The new model encourages nurses and care coordinators to determine carefully how the center manages and provides care to each patient. While the system prevents over-delivering therapy, it also ensures PDPM therapy is not under-delivering. PDPM prevents patient neglect, and poor outcomes as the Centers for Medicare & Medicaid Services (CMS) can issue facility f-tags and give the facility a lower quality rating. Therefore, PDPM medicare ensures nurses accurately document procedures and personalize services according to each patient.
2. Improves Financials
The patient-driven payment model promotes improvements in your center's financial stability. It encourages accurate reimbursement calculations according to the services provided. The primary function is to offset therapy reimbursement losses with more accurate calculations. This way, you can maximize PDPM reimbursements while providing optimal care.
As your facility is accurately reimbursed, you can free up resources in your budget and reallocate them to other areas. Ultimately, the PDPM medicare system exists to improve patient satisfaction and outcomes.
