Coding intensity and Medicare expenditures increased at skilled-nursing facilities after the implementation of the Patient Driven Payment Model in October 2019, according to a study published July 21 in JAMA Internal Medicine.
The Patient Driven Payment Model shifted reimbursement from a therapy volume-based payment to a payment based on clinical and functional patient characteristics, the study authors said.
For their analysis, researchers evaluated data of 2,065,809 Medicare beneficiaries who received post-acute care after hospitalization between January 2018 and February 2020.
Here are three notes from the study:
- The Patient Driven Payment Model was associated with a 0.54 point increase in coding intensity and a $665 increase in expenditures per care episode within skilled-nursing facilities.
Increased expenditures were associated with beneficiaries in for-profit facilities and with higher clinical needs. - The payment model was not associated with significant changes in 30-day rehospitalization or mortality rates.
- “These findings suggest that skilled nursing facilities responded to Patient Driven Payment Model incentives through changes in coding practices,” the study authors wrote. “[The findings underscore] the importance of continued monitoring to ensure that the financial incentives of PDPM promote accurate coding, equitable reimbursement and high-quality care.”
Read the full study here.
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