SNF's Moral Dilemma - Patient-Driven Payment Model
With the new Medicare A reimbursement system, Patient-Driven Payment Model #PDPM, coming in 2019, #CMS is on the path to transforming post-acute care payments to shift the industry away from fee-for-service payments and the over-utilization of therapy services.
It is concerning that the proposed model trims PT, OT and non-therapy ancillary pay over specific periods, while pay for speech language and nursing services would hold steady throughout a stay. In fact, a CMS representative is quoted as stating, “The minimum amount of therapy that should be delivered to SNF patients is the amount that they need.”
In conclusion, much of the PDPM’s regulations and guidelines could be concerning to those of us in the therapy industry. If the SNF is going to get paid for PT, OT and ST even when services are not being provided, SNF administrators may be faced with a moral dilemma. Will the they choose the money over quality patient care... only time will tell.
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