Understanding How Changes in SNF Medicare Payment Affect SLPs

By now, most speech-language pathologists in health care setting have heard about major changes coming to the way Medicare pays skilled nursing facilities (SNFs), effective Oct. 1. The patient-driven payment model (PDPM) bases Medicare reimbursement to SNFs on a patient’s clinical presentation rather than on the amount of time they need treatment. Here are the PDPM facts and  tips—both financial and clinical—for SLPs in SNFs. Know the facts Medicare is changing how it pays SNFs, but not the longstanding requirement that only medically necessary services are reimbursed. The Centers for Medicare and Medicaid Services (CMS) does not regulate the daily decisions SLPs make on behalf of their patients. CMS also does not set productivity standards, dictate who can provide services—such as swallowing or cognitive treatment—or require the evaluation of every patient, either under the old system or PDPM. CMS does expect providers to base services on patients’ needs and benefits of the treatment. So, what does this change mean? First, the change emphasizes value over volume across the health care system. There is also interest in developing a unified post-acute care Medicare prospective payment system (PPS) that would create a single approach for reimbursing services provided in SNFs, home health, inpatient rehabilitation facilities, and long-term care hospitals—all of which now have different systems. In fact, a payment model similar to PDPM, known as the patient-dri...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Slider Speech-Language Pathology Professional Development Source Type: blogs