Patient-Driven Payment Model
PPDM, the Patient-Driven Payment Model will be effective October 1, 2019. The model is intended to reduce the number of payment group combinations and to simplify paperwork requirements.
CMS reports the new case-mix classification system will use certain clinical factors rather than volume based services to determine Medicare reimbursement. Classification will be based on the primary diagnosis for the resident’s stay, therapy components, and the resident’s functional status to assign one of 16 case mix groups.
LTCS books will be updated by October to include the changes. The link below provides detailed information, crosswalk tables, and learning materials.
