4       0

AMDA Self Study Webinars


The Quest for Quality: Red Flags in Skilled Therapy and the Changes Required by the Planned Transition to the New Patient Driven Payment Model (PDPM)


May 1, 2019 7:00pm ‐ May 1, 2019 8:30pm


Credits: None available.

Standard: $99.00
Members: $0.00

Description

This presentation, using case examples, will focus on two major issues facing skilled nursing facility care: the risks and opportunities created by the combination of the current Resource Utilization Groups (RUGS) reimbursement system and the federal government’s increasing use of “Big Data” to identify potential outliers using a set of metrics; and the changes involved with the soon-to-be-implemented Patient Driven Payment Model (PDPM).

Learning Objectives:

  • Explain the concepts of medical necessity, false claims and worthless care in relation to the quality of care in the skilled nursing facility setting, and how to apply these concepts
  • Describe the processes The Centers for Medicare & Medicaid Services (CMS) and other governmental entities use to evaluate medical necessity, potentially false claims and potentially worthless care in post-acute care
  • Discuss how post-acute long-term care providers and medical directors may be asked to participate productively in these processes to provide clinical insight and interpretation to both resolve concerns and proactively minimize risk going forward
  • Define the soon-to-be-implemented Patient Driven Payment Model (PDPM) and improve participants’ readiness to respond to this new reimbursement system for skilled care in skilled nursing facilities

Speaker(s):

Credits

  • 1.50 - Management
  • 1.50 - MOC

You must be logged in and own this session in order to post comments.

Print Certificate
Review Answers
Print Transcript
Completed on: token-completed_on
Review Answers
Please select the appropriate credit type:
/
test_id: 
credits: 
completed on: 
rendered in: 
* - Indicates answer is required.
token-content
token-speaker-name image
token-speaker-name
token-index
token-content
token-index
token-content
token-index
token-content
token-index
token-content
token-index
token-content
token-index
token-content
/
/
token-index
token-content