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Patient-Driven Payment Model (PDPM) Readiness Services
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PDPM to RUGs Financial Impact Analysis  

PDPM reimbursement system will impact each SNF differently, some will have financial gains, and others will have financial losses. Polaris Group can help predict the financial impact of PDPM on your SNF. Our Financial Consultant will audit a sample of recent Part A stays, calculate the PDPM Case Mix Groups for each, then compare payment for PDPM to the payment received under RUGs for an Impact Analysis.

Objectives:

  • Expert impact analysis of recent Part A stays comparing PDPM recenue to RUGs revenue for each.
  • Calculate cumulative impact based on total sample of difference in revenue under PDPM compared to RUGs.
  • Provide PDPM Training Introduction to team members.
  • Evaluate current knowledge base and make recommendations for training or systems needed for success.

Audit:

  • Audit a sample of recent Part A stays:
    • Calculate PDPM Case Mix Groups from 5-day MDS
    • Data gather RUG billed and number of days under current reimbursement system
    • Calculate the impact positive or negative

Benefits:

  • PDPM Case Mix Group calculations from recent Part A stays that reflect current population.
  • Provides insight into financial impact of PDPM revenue when compared to RUG revenue for same resident.
  PDPM Training - How it works
  Full PDPM MDS Audit
  PDPM Right Start - Comprehensive Services
  Focused ICD-10 Coding Accuracy Training and Audit
  MDS Coding Accuracy for PDPM Training
   Focused GG Audit and Training
  Transition Services
Other PDPM Support Services:
   Medicare and PDPM Compliance Audits
  Key Indicator Trend Reports - Claim data trending services
  PDPM Manual with policies and procedures
  Billing Manual with policies and procedures
  Solution Center Hotline
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