• Skip to primary navigation
  • Skip to main content
  • Skip to footer

Net Health

Purpose-built EMR Software + Solutions for Outpatient Care

Home

Solutions

Therapy

SNF & Senior Living
Hospital Outpatient
Private Practice
Home Health
Acute Care

Wound Care

Hospital Outpatient
Private Practice
Data Solutions

Occupational Health

Employee Health for Hospitals
Employee Health for SNFs
Occupational Medicine Clinics

Hospice

Hospice Management

Telehealth

For SNF & Senior Living Therapy
For Hospital Outpatient Therapy
For Private Practice Therapy
For Home Health Therapy

For Wound Care
For Hospital Employee Health
For Occupational Medicine

Digital Marketing Services

For Therapy
For SNF & Senior Living
For Wound Care
For Occupational Medicine

Professional Services

For Therapy
For Wound Care
For Hospital Employee Health
For Occupational Medicine

Revenue Cycle Services

For Hospice
For Occupational Medicine

Resources

Net Health Resources Page, Webinar, green image
Outpatient Therapy

Grow Your Rehab Therapy Practice Using Paid Ads and Search Engine Marketing

When done right, paid advertising and search engine marketing are amazing tools to reach new patients and grow your business. By applying several basic tactics, you can start using powerful digital advertising platforms like Google and Facebook to target specific audiences and help ensure a steady flow of business for your practice. Click to View […]

Click to View Webinar
Net Health Resources Page, check mark, red image
Hospice

Five Key Stressors Hospice Professionals Face, with Guidance for Support

Hospice professionals help others face death and loss, while juggling interdisciplinary communications, quality compliance regulations and ever-evolving technologies. You are continually there for families and their dear ones who are passing away. But what about you? Get the eBook In caregiving professions, it is easy to get swept up in the needs of others and forget […]

Get the eBook
Sales: 800.411.6281
Please make a solution selection below and we will be in touch with you to schedule a demo.

Blogs + Articles

Browse all blogs
SNF & Senior Living Therapy
Outpatient Therapy
Home Health Therapy
Wound Care
Employee Health
Occupational Medicine
Hospice

Resources

Resource Hub
Webinars
Videos
Case Studies
eBooks
White Papers

About

Jason JJ James, CIO, SME blog image
Leadership

Net Health’s CIO discusses diversity and how it can build a stronger organization

Diversity in the workplace is an on-going issue but it’s an issue with solutions. To build diversity, it takes forward-thinking initiatives, a reexamination of the hiring philosophy, and the support of the company’s decision-makers.  One such supporter of diversity in the workplace is Net Health’s CIO, Jason “JJ” James.  Recent social movements like Black Lives […]

Read More
Net Health's Fireside Chat on Race blog image
Our Culture

Tough Questions | Real Answers: Net Health’s Fireside Chat about Race

Net Health did something different recently. Nearly two hundred employees and their families gathered around their computer screens to take part in a landmark event in our company’s history – we called it a “Fireside Chat about Race”.  The purpose of this event was to have a truly open conversation about the controversial but relevant […]

Read More

About Net Health

Company
Leadership
Partners
Careers
Press Releases

Contact

Login

Agility

844.464.9348

CliniSign

772.403.1301

Hospice

855.417.1420

Net Health U

Optima Therapy

772.403.1301

Net Health Therapy
(formerly ReDoc)

844.464.9348

Net Health Wound Care
 (formerly WoundExpert)

844.464.9348

Schedule a Demo
Resources Understanding the Patient-Driven Payment Model (PDPM)
Video | SNF + Senior Living

Understanding the Patient-Driven Payment Model (PDPM)

 

What is PDPM?
The Patient-Driven Payment Model (PDPM) is the proposed new Medicare payment rule for skilled nursing facilities. It is intended to replace the current RUG-IV system with a completely new way of calculating reimbursement. Under PDPM, therapy minutes are removed as the basis for payment in favor of resident classifications and anticipated resource needs during the course of a patient’s stay. PDPM assigns every resident a case-mix classification that drives the daily reimbursement rate for that individual.

How will PDPM affect my therapy business?
We expect PDPM to impact your therapy business in the three significant ways.

Managing care – Unlike RUG-IV, which incentivizes ultra-high volumes of therapy to capture the maximize payment, PDPM will require you to carefully manage how you deliver services in order to provide just the right level of care for each resident. SNFs who over-deliver therapy won’t get paid for services provided beyond the reimbursement level for each resident classification. But under-delivering therapy will lead to poor patient outcomes and potential Medicare audits and take-backs.

Staffing – With a reduction in total therapy minutes provided, you can anticipate less demand for therapists in the SNF setting. This should help ease some of the burden associated with recruiting qualified staff, making it easier for you to find and retain the best therapy resources.

Financial – PDPM is designed to be budget neutral. Within SNFs, this is expected to be true. With some therapy dollars reallocated to nursing, SNFs will be able to offset the loss in therapy reimbursement with higher reimbursement for the nursing care that’s already being provided. From a revenue perspective, contract therapy providers will see a reduction in revenues. However, because of the provisions that have been made under PDPM, it’s very possible to achieve neutral to positive profit margins, while increasing patient outcomes.

What do I need to do to prepare?
With a proposed October 2019 implementation date, it’s important to start laying the groundwork now for the changes. We’ve identified four keys to success under PDPM:

1. One is to lower costs. You’ll need to enable each therapist to provide more treatment to more patients through the use of group and concurrent modes of treatment.

2. The second is to improve the patient outcomes. This can be achieved by establishing data-driven protocols based on the clinical evidence to suggest a care plan that takes into account the reimbursement level for each patient and the outcomes model that CMS has embedded into PDPM with Section GG data.

3. The third is to augment revenue sources. Start by identifying the residents in your SNF who are not currently covered by Medicare Part A but would benefit from therapy services.

4. Finally, optimize the reimbursement that you’re due. This means ensuring that your patients are being classified correctly and that your SNF and, by extension your therapy provider, are reimbursed appropriately for each resident that you see.

EMR software with advanced business intelligence (BI) and data analysis tools can help you predict your future needs and manage costs under PDPM, as well as provide customizable treatment protocols that will allow you to deliver the appropriate level of care for each unique resident. Ask your EMR vendor what capabilities they will have to support your transition.

Related

LinkedinShareTweetMailPrint

Footer

About

  • Company
  • Leadership
  • Careers
  • Locations
  • Our Culture | The Buzz
  • Press Releases

Resources

  • Resource Hub
  • Our Blog
  • Client Services

Care Settings

  • Hospital
  • Post-Acute Care
  • Private Practice

Sales

800.411.6281

Copyright © 2021 · Net Health · Sitemap · Privacy Policy