Welcome to thought leadership

PDPM: What has changed and what hasn’t

By RehabCare

With the implementation of the Patient-Driven Payment Model (PDPM), it’s important to understand what changed, what remains the same, and the critical role of the highly skilled clinician in a patient’s care.

What has changed?

  • Value-based rather than volume-based care
  • Variable reimbursements
  • Documentation is needed to support every component of PDPM

The value-based system makes it necessary for interdisciplinary teams (IDTs) to work closely together. Strong care collaboration will ensure the best outcomes for patients and is needed to satisfy the documentation requirements of PDPM.

Based on the new reimbursement system, documentation for each component of a patient’s care will be vital to support services billed, not solely based on therapy services.

PDPM: What has changed and what hasn’t

What hasn’t changed under PDPM?

  • Medicare’s definition of skilled care
  • Value-based purchasing system
  • The need to discharge patients to an appropriate setting

Medicare’s skilled care criteria remain unchanged, as does the value-based purchasing program. That’s because therapy has shown to have a huge impact on reducing lengths of stay and readmission rates, and improving functional outcomes and quality of life.

This is particularly important, considering research shows functional status is a better predictor of hospital readmission rates than comorbidities.

PDPM payment reinforces that every clinician on an IDT needs to be aware of — and understand — the patient’s care plan. Highly trained clinicians have the expertise, critical judgment and thinking skills necessary to not only carry out a therapy plan but also recognize when changes or adjustments need to be made, as well as the ability to properly document for the purpose of PDPM reimbursement.

For more information about PDPM, read our white paper.

RehabCare is the expert in PDPM. To learn how we can help your facility adapt to PDPM and produce the best possible patient outcomes, contact us by calling 800-545-0749 x 7640.

By RehabCare