How to Transition to PDPM Without Missing a Beat

June 11, 2019 ABILITY

The patient-driven payment model (PDPM) goes into effect in just a few months. Skilled nursing facilities (SNF) have until October 1 to make the transition. Is your facility ready?

Established by the Centers for Medicare and Medicaid Services (CMS), PDPM represents a shift from fee-for-service care to value-based care models. Successfully transitioning to PDPM will involve a three-pronged strategy for SNFs:

  • Optimizing efficiency in providing care
  • Enhancing patient experience
  • Improving patient outcomes

In a value-based care model such as PDPM, instead of billing patients based on the number of services you provide, you’ll bill them based on their outcomes. They key to maintaining revenue during this transition lies in capturing and managing data.

A deeper look into each step of the transition strategy, as well as how to best use the data you collect, can help your facility transition to PDPM without missing a beat.

Optimizing efficiency in providing care

When you optimize how you care for your residents, you may find untapped, justifiable reimbursement revenue that you would have otherwise left on the table.

With ABILITY CAREWATCH®, you can use the Resource Utilization Group (RUG) Potential tool to view RUG groups before you transmit your assessments. This will allow you to plan ahead for the next Minimum Data Set (MDS) assessment and ensure that you are properly reimbursed for each resident’s care and the services you provide.

Enhancing patient experience and improving outcomes

When your organization is reimbursed based on the quality of your patients’ experiences and outcomes, data becomes an indispensable tool. The right data applications help you keep track of where you stand on crucial quality measures. Tracking your Five-Star rating, for instance, allows you to clearly see how your facility compares with others, where you are succeeding and where you need to improve.

Another important metric to watch is acute care readmissions so you can identify at-risk residents. Data-driven applications offer SNFs the opportunity to pinpoint exactly where they need to improve for a seamless transition to PDPM.

Accurate MDS assessments for better reimbursements

Also, to improve patient experience and outcomes, SNFs must have the power to create enhanced care plans with accurate analysis of the MDS. With the right tools, you can catch MDS issues early and boost assessment accuracy for better care plans. With accurate MDS assessments, you’ll also be empowered to find more reimbursement opportunities, ensuring that you collect more of the revenue that you are owed.

Data-driven applications are crucial to easing your transition to PDPM and helping you improve patient outcomes.

For more resources on transitioning to PDPM, as well as other relevant industry info, visit the ABILITY resource center.

The post How to Transition to PDPM Without Missing a Beat appeared first on ABILITY Website.

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