As part of overall efforts to move Medicare payment away from fee for service and toward a structure that holds providers accountable for patient outcomes and costs, the Centers for Medicare and Medicaid Services (CMS) has made significant changes to the home health and skilled nursing facility (SNF) payment systems. The SNF Patient-Driven Payment Model (PDPM) began October 1 and the Home Health Patient-Driven Groupings Model (PDGM) (.pdf) began January 1, 2020. Both of these payment systems align payment with patient characteristics, conditions, and needs, and eliminate the connection between reimbursement and the volume of therapy services provided—time spent and number of visits. This change makes it ever more important to show the value and cost-effectiveness of physical therapist services within SNFs and home health care.
CMS finalized updates to the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) payment rates using the most recent data to reflect an estimated 2.5% increase factor on October 1, 2019. Changes also included the removal of the Functional Independence Measure (FIM(tm)) items from the IRF patient assessment. The removal of the FIM(tm) items necessitates using different items from the quality indicator section of the IRF patient assessment instrument (quality indicator items) that capture similar information on functional status to classify patients into payment groups.
In this two-hour webinar, industry experts will provide you with an in-depth analysis of the recent changes in Medicare Part A rules and regulations and what you can expect in 2020.
Following this webinar, the participant will be able to:
- Identify documentation requirements for quality indicators throughout post acute care for 2020.
- Understand changes in payment across inpatient rehabilitation, skilled nursing and home health for 2020.
- Express understanding of the previous payment model (RUGs-IV) as compared to the newly implemented payment model (PDPM).
- Be aware of CMI (Case Mix Index) and its implication for diagnosis and payment.
- Describe the amount of therapy service to be provided based on diagnosis.
6:00 – 7:45 p.m. Presentation
7:45 – 8:00 p.m. Q&A
Stephanie Kaplan, PT, DPT, ATP is the Hospital Administrator and Director of Rehabilitation at Casa Colina Hospitals and Centers for Rehabilitation in Pomona, CA. With over 19 years of clinical and leadership experience, Dr, Kaplan’s focus has been on treating persons with neurologic impairments, research on falls in the rehab setting and program development. She has experience implementing three electronic health record systems and reviewing charts for CMS audits. She is currently a member of the Payment Policy Committee of the CPTA and former Board Member for CPTA. Dr. Kaplan also serves as a CARF surveyor.
Diane Blagojevich is the Clinical Manager for Providence Little Company of Mary Home Health. She is a 1990 graduate of CSU, Northridge with a certificate in Physical Therapy and Bachelor of Science, Health Science. Diane, also, a Bachelor of Arts in Medical Sociology. She has been in practice for 28 years in a variety of settings with home health being 22 of those years. She is a member of the APTA Home Health Section and a member of the CPTA Payment Policy Committee. Her current practice includes staff management, competency and program development, patient care, compliance, mentorship in staff shared decision making groups, marketing and IT assistance.
Marilyn Washington is a graduate of UC San Francisco, Physical Therapy Program. Marilyn's current position is Vice President of Rehabilitation Services for Bio-Pacific Therapy currently providing rehabilitation services to Mariner Healthcare's Northern and Southern California Skilled Nursing Facilities. Marilyn's work experience includes acute, inpatient rehabilitation, outpatient, home health, and for the past 18 years, skilled nursing rehabilitation. Marilyn has served as adjunct professor at Mount St. Mary's PT Program, and guest lecturer at USC's PT Program, as well as, Mount St. Mary's PTA Program. Association activities include former Director and Vice President of the CPTA, and member and Chair of the American Physical Therapy Association Minority Affairs Committee.
2.0 contact hours or 0.2 CEUs
Instruction Level: Basic
Format: Lecture with on-line Q&A. Text with the speakers during the live presentation.
Target Audience: PT, PTA, and Students. Open to all Allied Health Professionals
Registration received by February 20, 2020
$25 APTA PT members
All cancellation requests must be received in writing – no exceptions. A full refund, less 20% service fee, if cancellation is received before February 20. No refunds on or after February 20, 2020.