September 6, 2019
It’s obvious that with a change as big as PDPM that there will be myths that begin to spread about what life will be like after October 1. To help guide your decision-making it is important to get the facts from a trusted source. That’s why Aegis is taking on the role of PDPM Mythbuster to tackle the top five myths circulating today.
1. Patients will receive less therapy under PDPM.
Patients will continue to receive the clinically appropriate care, when they need it. The goal remains to do this without compromising results and outcomes. With a heightened focus on outcomes under PDPM, some areas may see a decline in the number of individual therapy minutes delivered, however that could be the result of increased efficiencies in care delivery, including the appropriate use of group and concurrent practices.
2. Staff reductions are to be expected after Oct. 1.
Every facility has unique staffing needs, and this will not change under PDPM. Aegis Therapies anticipates that some locations may have staff hours shifted or reallocated resulting in an overall reduction of hours due to clinical service delivery flexibility. The majority of any reduction is expected to be accomplished through attrition; reduction in use of PRN labor. Aegis will first focus on covering reduction of therapy hours by re-evaluating open positions and reducing PRN usage. Therapists can expect any changes to be purposeful and strategic and will not impact delivery of care nor outcomes achieved.
3. Group and concurrent therapy utilization should remain the same as it is today.
No. Aegis anticipates an appropriate increase in the utilization of group and concurrent therapy under PDPM. Through the shift to PDPM, CMS still believes that the majority of any patient’s therapy time should be individual. Aegis agrees, however, we recognize the value and effectiveness of alternative delivery options based on clinical evidence which supports the efficacy of group intervention with select patients. In fact, our internal outcomes data has shown similar or even improved outcomes with the inclusion of group treatment. Therapists must be very aware of the reimbursement requirements and differences between payer sources, so the forward planning for group therapy is critically important. The regulations around group therapy under PDPM require appropriate documentation in each patient’s plan of care, and the group must be planned in advance. Aegis has and will continue to provide information and training to staff in preparation for this enhanced clinical opportunity to ensure utilization in a clinically appropriate and patient-centered manner.
4. In order to be efficient, therapy must be provided by an in-house model.
No. Therapy services provided by a contract therapy company can help achieve efficiencies that can be harder to accomplish in an in-house model. For example, a contract model allows skilled nursing facilities the ability to focus on their core business of nursing, while allowing therapy experts to focus on delivering rehabilitation services and implementing changing regulations. In a changing healthcare environment, therapy competencies are more important than ever to achieve expected outcomes, positively influence quality measures and control cost of care. Other advantages of a contract model include enhanced clinical training, strong quality and compliance oversight, analytics and recruitment support.
5. PDPM will result in skilled nursing facility losses.
Some providers may see losses under PDPM, however this does not have to be the fate of every facility. Having a strategic plan in place to face changing regulations head on and understanding how reimbursement will be calculated under PDPM is vital. Look for a therapy provider, like Aegis Therapies, with analytical support that can identify opportunities in virtually all facilities and help you understand how your operations may need to change under PDPM.