The Real Truth of PDPM: HDG Provides Early Learnings for Senior Leadership

Posted on February 25, 2020 by Jodi Boyne

It’s been five months since the Patient-Driven Payment Model (PDPM) went live. What have we learned since then? Let’s check in with Health Dimensions Group, who recently shared some early learnings at our Institute & Expo and recapped their presentation in a new blog post “The Real Truth of PDPM.” 

Early indications for financial performance have been positive, but that news should be met with a note of caution as PDPM was created to be budget neutral. Look for increased scrutiny on financial and clinical outcomes, including analysis of coding creep, payment weight calibration and margins analysis.

There are some common challenges being experienced by providers, from completing functional scores timely and accurately and determining when to do Interim Payment Assessments to identifying “daily skilled need” when therapy is not the primary reason for skilled care or when the patient is discharged from the therapy case load, among others.

Operational processes must be well-documented. Make sure to conduct clinical coding accuracy and documentation audits to confirm that payment-sensitive items are accurately and completely captured.  

And now would be a good time to review therapy contracts and performance.

For more information and steps you should be taking now to seize opportunities and address challenges under the new payment system, read The Real Truth of PDPM.