McKnight's April 12, 2021
A recalibration to the Patient Driven Payment Model could have troubling payment implications for skilled nursing providers who are still trying to manage a difficult operating environment caused by the pandemic, experts are warning.
The Centers for Medicare & Medicaid Services revealed that it wants to recalibrate PDPM’s parity adjustment after finding the agency’s aggregate spending under the new model increased unintentionally by 5.3%, or $1.7 billion, when compared to what it would have paid SNFs under the old Resource Utilization Group model.
“As a result, it would appear that rather than simply achieving parity, the FY 2020 parity adjustment may have inadvertently triggered a significant increase in overall payment levels under the SNF [Protective Payment System],” the agency...
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