The Centers for Medicare and Medicaid Services (CMS) will be changing the Skilled Nursing Facility (SNF) prospective payment system to the Patient-Drive Payment Model (PDPM) which goes into effect October 1, 2019.
Therapy minutes are a thing of the past. The new model is designed to address the needs of the patient, instead of focusing on the volume of services the patient receives. There will be no transition of payment models. Providers will bill under RUG-IV up until September 30, 2019 and PDPM will begin on October 1, 2019.
Under PDPM, SNFs will need to accurately capture and document patient characteristics for reimbursement. The primary reason for the SNF stay will be a key criterion of reimbursement. SNFs must have the expertise and skill set to not only identify the primary reason for the SNF stay, but also document it for reimbursement purposes. At Blue Sky, we are outcomes and data experts! By partnering with Blue Sky, we will help you measure your outcomes, showcase your value to existing and future residents and maximize reimbursement rates to protect your bottom-line.