PDPM - The Patient Driven Payment Model

Advion 2022 Issue Briefs:


Expand Medicare Beneficiaries’ Access to Digital Health, Including Telehealth & Remote Patient Monitoring  (Feb 2022)


Support the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act of 2021 (H.R. 5536) (Feb 2022)


Hospital Observation Status Harms Beneficiaries' Access to Medicare's Skilled Nursing Benefit




The Patient Driven Payment Model (PDPM) is the new reimbursement system
model that Medicare will use to determine payments for SNFs starting on
October 1, 2019. PDPM replaces the current Resources Utilization Groups (RUGs)
model.  PDPM fits into a broader push by CMS toward “patient-centered”
reimbursement models that match payment rates to the patients’ needs.


PDPM Resources:


CMS’ Patient Driven Payment Model webpage, containing CMS’ latest documents on PDPM: 
Fact Sheets, FAQs, Training Presentation, Beta version of the Grouper, and ICD-10 Mappings.


PDPM – What is Changing and What is Not?
Presentation by John Kane of CMS to NASL 2019 Winter Conference




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