How Therapy Can Help Drive Reimbursement Post-PDPM

Did you see our How to Succeed Post-Implementation of PDPM Webinar?

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Our previous PDPM webinar was about the measures you should be taking to succeed post-PDPM implementation across your organization. Therapy specifically plays a key role in that success by contributing in the following ways.

 

Blue Sky has created a new position in each of our partner facilities with the implementation of PDPM. At Blue Sky, we pride ourselves on being collaborative partners. Our therapists have been educated and trained on how to identify the diagnoses’ that drive PDPM, what the coding requirements are on the MDS and the proper service delivery pathways. These invaluable components’ drive care and your reimbursement. With the transition to PDPM, Blue Sky has created a new position: Blue Sky Rehab Care Managers. As an integral member of the care team, we have redesigned the role of our Rehab Managers to reflect the changing care delivery model under PDPM. We have created competency-based assessments and skills check that have made our Rehab Care Manager a VITAL component to your team.

First, we know Medicare is going to be tracking therapy minutes, but more importantly, they will be reviewing outcomes. It is essential to make sure that therapy was delivered effectively and efficiently to achieve the optimal outcome for the patient. The service delivery should also now be variable. This is a patient-driven system. There are no longer arbitrary thresholds that the therapists must meet. The other focuses for therapy are whether the service delivery is appropriate for the resident and does the therapist’s documentation support that service delivery? And as always, does it reflect a skilled need?

Blue Sky Therapy has been collecting outcomes since 2014. There is significant data behind the therapy we provide. Does your current therapy provider track outcomes? Do they look at each patient’s outcome at discharge and evaluate what the service delivery was to get that outcome? These are important questions to answer now post-PDPM implementation.

Therapists are also going to be critical in helping the MDS coordinator drive reimbursement. The MDS has moved from 60 sections to about 180 sections. The therapy team should know and be accountable for their sections of the MDS. The therapists should be checking off that they have entered all the pertinent information for the MDS for every resident they treat. Therapists should also be essential members of your Interdisciplinary Team. Prior to all IDT meetings, each team member should be responsible for completing their evaluation of the resident. The therapists should be discussing the results of their evaluations and provide their thoughts on the primary and other secondary diagnoses and Section GG.

At Blue Sky, we pride ourselves on being collaborative partners. Our therapists have been educated and trained on how to identify the diagnoses that drive PDPM, what the coding requirements are and their components, the different areas of the MDS, etc. With the transition to PDPM, Blue Sky has also created a new position: Blue Sky Rehab Care Managers. As an integral member of the care team, we have redesigned the role of our Rehab Managers to reflect the changing care delivery model under PDPM.

As always with Blue Sky, we will provide only compliant driven care. We collaborate and provide patient driven information that reflects the care and resources to be captured for the best possible treatment and outcomes. Our team is prepared to assist the other members of the Interdisciplinary Team with our PDPM Roadmap for Success, established processes, and exceptional communication so that the entire organization can thrive under PDPM. Do you want to learn more about how Blue Sky can partner with your organization to succeed post-PDPM implementation? Click here to schedule a 15-minute Blue Sky Discovery Call!

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