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Live In Person Seminars

Patient-Driven Payment Model Are You Ready for Change (Perrysburg)


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Patient-Driven Payment Model - Are You Ready for Change?

4 CEUs for NHA, CPA, Nurses

November 1, Perrysburg

In August, CMS finalized plans to move from the Prospective Payment System in place since 1998 to a patient characteristics based payment system, known as Patient-Driven Payment Model (PDPM) effective October 1, 2019. This represents the most significant change in Medicare reimbursement methodology in over 20 years and providers need to begin to prepare now if they want to be successful under the new system.

This session is appropriate for administrators, directors of nursing, MDS nurses, therapists, admissions and billing personnel and will discuss:
* Detailed description of the new model
What are the five rate components?
What grouper methodology will be used for each component?
How does the rate tapering work?
What assessments will be required?
* Resident specific case studies
How ill the rates under PDPM compare to PPS rates for the same resident?
* Operation considerations to help providers be more successful under the new model
How should the team evaluate potential admissions and predict payment rates?
How should the role of the MDS nurse change?
How should care pathways change since reimbursement rates will no longer be tied to therapy minutes delivered?
How will the billing process need to change

While CMS has calibrated the new model to be budget neutral across all providers, individual facilities could see dramatic changes in their annual Medicare revenue as a result of the new system. There are many strategic and operational decisions and changes that should be made prior to the October 1, 2019 implementation date if you want to be ready.
8:00 am Check In & Continental Breakfast
8:30 am Program Begins
10:30 am Break & Snack
12:45 pm Adjourn

November 1, Perrysburg
Hilton Garden Inn Perrysburg
6165 Levis Commons Boulevard
Perrysburg, Oh 43551

This session will be presented by Robin L. Hillier, CPA, STNA, LNHA, RAC-CT. Ms. Hillier is a member of the American Health Care Association Reimbursement Cabinet and has been intimately involved with the development of the PDPM. She was part of a small contingent who met regularly to discuss concerns and challenges with the original CMS proposal and was instrumental in several improvements to the system. She has also been part of a pilot group who evaluated the effects the new model would have based on actual beneficiary claims, which has given her keen insight into the operational changes necessary to be successful.
Continuing Education Credit::

This program has been approved for four hours of continuing education credit for nurses, accountants and nursing home administrators.
Registration Fees:

OHCA Members:

$85 prior to October 1
$125 October 1 and after

All Others:

$125 prior to October 1
$165 October 1 and after