The transition from a volume-based to a value-based mindset is critical for the long term balance of our healthcare system. The way we see it, PDPM is another step in the right direction for CMS and the future of therapy services.
CMS Administrator, Seema Verma, stated: “We envision all elements of CMS’ healthcare delivery system working to reward value over volume and decisively focus on patients receiving quality care from their Medicare benefits.” As a result of this shift, unless they adopt a new approach, providers will be expected to achieve the same rehabilitation results while decreasing their OT/PT hours by 30%. Failure to do so means the same patient outcomes will result in a loss of compliance with payers.
Moving forward, CMS says practitioners must deliver patient-centered care. Therefore, SNFs should focus on treatments that address the care their residents genuinely need. For instance, facilities should invest in therapy treatments that are both designed and backed by data because we know that such interventions lead to more favorable results. In the PDPM economy, data-driven tools are the key to producing optimal clinical outcomes.
These changes, as exciting and promising as they are, require planning and interdisciplinary communication. Above all, both nursing and therapy goals should be functionally focused, specific to the patient’s barriers to discharge, and uniformly addressed. Preparing for PDPM necessitates a system such as RESTORE.