This content is reprinted from a Skilled Nursing News digital magazine article written by Maggie Flynn and published on March 12, 2020. Read the full article here.
The Patient-Driven Payment Model (PDPM) was specifically designed to reimburse skilled nursing facilities based on the condition of the patients that they treat, rather than by the minutes of therapy provided to those patients.
As part of the change, the Centers for Medicare & Medicaid Services (CMS) included a 25% cap on group and concurrent therapy services for patients, service types that had been mentioned in the months prior to the implementation of PDPM as a potential area for operational savings.
But one of the concerns that the agency expressed about the changes was that the decision to use group therapy would be required by employers, rather than driven by clinicians — a concern shared by the major therapy associations, according to Ellen Strunk, owner of Rehab Resources and Consulting, Inc., on a Wednesday webinar hosted by Optima Healthcare Solutions, part of the Pittsburgh-based Net Health.
A survey from a post-acute care workgroup — consisting of the American Physical Therapy Association (APTA)–Geriatrics, the Home Health section of the APTA, and the health policy administration section of the APTA — seemed to suggest those concerns have some validity, at least in the early going.
The survey, which had more than 1,700 total respondents, found that of those who worked in a SNF, about 60% to 65% said their utilization of concurrent and group therapy had increased, Strunk noted.
“Unfortunately, of those responding to the post-acute care workgroup survey, more than half said that those changes were mandated by their employers,” Strunk said on the webinar. “Twenty percent said that their provider only encouraged the use of more concurrent or group therapy.”
Later in the discussion, she did add the caveat that the survey did not distinguish who was responding to what question, and so some of these answers could have come from home health therapists. It’s also not clear what the distribution of therapists by discipline was.
But the bigger picture has to be considered, Strunk said.
“Remember, there is a patient at the center of this,” she said. “So if treatment minutes or visits are declining, then we ask why. When we change our model of care, there are going to be some changes. What we as therapists have to be mindful of is whether those changes are appropriate.”
