Patient-Driven Payment Model (PDPM)

The Patient-Drive Payment Model (PDPM) is here, and AANAC will continue to help you through the transition. Visit this page frequently for new tools, education, and resources for ongoing success under PDPM.

CMS Makes Direct Link Between Outcomes and Medical Review

Posted By: Caralyn Davis, Staff Writer
Post Date: 09/11/2019

Under the Patient-Driven Payment Model (PDPM), resident outcomes will be key to avoiding medical review, said officials with the Centers for Medicare & Medicaid Services (CMS) during the August 14 Skilled Nursing Facility Quality Reporting Program (SNF QRP) training session, Patient-Driven Payment Model: What Is Changing (and What Is Not). Note: Find the session slides here.

 

The goal of PDPM is for SNFs to provide value-driven care, said officials. “Fundamentally, it comes down to a balance. A high-value and efficient provider is one that is able to achieve high-quality outcomes at low cost.”

 

CMS measures SNF quality of care in three main ways:

  • The SNF QRP;

  • The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program; and

  • The Five-Star Quality Reporting System on Nursing Home Compare.

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