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The Patient-Driven Payment Model (PDPM): Strategies for Implementation & Keys to Success (Recorded Webinar)

presented by Ellen R. Strunk, PT, MS, GCS, ACEEAA, CHC, RAC-CT

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Disclosure Statement:

Financial: Ellen Strunk receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.


 Non-Financial: Ellen Strunk has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

Accreditation Check:

This course is a recording of a previously hosted live webinar event. Polling and question submission features are not available for this recording. Format and structure may differ from standard MedBridge courses. On July 31, 2018, the Centers for Medicare and Medicaid Services (CMS) finalized a new payment model to replace the Skilled Nursing Facility's (SNF) Resource Utilization Groups (RUGs) payment system with the Patient-Driven Payment Model (PDPM). This new model for Medicare Part A payment will be implemented for all SNF dates of service on/after October 1, 2019. This new payment model will create both opportunities and challenges for nurses, therapists, suppliers and SNF administrators, including: more emphasis on diagnoses, coding of comorbidities and other non-therapy ancillaries, Section GG coding, managing length of stay, and managing the amount and type of therapy delivered. Understanding these various components and how they interact with each other will be critical to the transition to PDPM.

Meet Your Instructor

Ellen R. Strunk, PT, MS, GCS, ACEEAA, CHC, RAC-CT

Ellen R. Strunk, PT, MS, GCS, CEEAA, CHC, RAC-CT, has worked in various roles and settings as both a clinician and a manager/director. Ellen is an expert at helping customers understand the CMS prospective payment systems in the skilled nursing facility and home health settings, as well as outpatient therapy billing for all provider types.…

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Chapters & Learning Objectives

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1. Describe the Components of PDPM

The Patient Driven Payment Model (PDPM) is the proposed SNF Payment System that correlates payment to the patients’ conditions and care needs rather than volume of services (Cost-Based) provided or resources rendered (PPS RUGs System). This chapter will describe the basis for changing the system and the essential components that calculate the new PDPM.

2. Define Staff Competencies to Support PDPM Success

Some therapists and nurses working in SNF know only the RUGs system. The RUGs PPS system focuses primarily on what service is delivered, rather than what the patient’s actual needs are. In a PDPM environment, will the clinical role of nursing, therapist, nursing assistant and physician change? This chapter will discuss the clinical and operational competencies team members may need in a PDPM payment world.

3. Define the Role of the Interdisciplinary Team

This chapter will focus on how data can be turned into knowledge, and how that knowledge can inform decisions about type and intensity of care delivered. Members of the interprofessional team are critical to this process. Evaluating facility practices to utilize an interprofessional model should remain a primary focus.

4. Develop Steps to be Ready for PDPM

What types of programs will a SNF provide under PDPM? Therapy programs, restorative care, activities are examples of effective patient care delivery that have a direct impact on many quality measures. Facilities and therapists should work together to insure the quality of care in SNFs does not suffer under PDPM.

5. Question & Answer Session

In this portion, Ellen answers questions submitted by learners attending the live webinar.

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