SNF PPS Final Rule FY19: Top 10 Things You Need to Know

The SNF PPS Final Rule was released 7.31.18. The Top 10 things you need to know. Here are the top 3. More in Kris’ blog. #rugs #cms #snf #pdpm

1) There is a 2.4% Medicare Part A Rate increase effective October 1, 2018 (Fiscal Year 2019). This equates to 820 Million dollars for the SNF industry.

2) Patient Driven Payment Model (PDPM) is the 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).

PDPM is effective October 1, 2019 (Fiscal Year 2020). The PDPM applies to Medicare Fee for Service (FFS) only patients and does not apply to Medicare Advantage (yet).

3) One component of the Patient Driven Payment Model (PDPM) is the tapering of payment the longer the patient stays. It is common practice for therapists to develop patient specific transitions of care. These mechanisms are not new but may have been overlooked under the current payment system.