NEMEP Session # 5 NEW MARKET OPPORTUNITY

Wednesday, November 11th at 1pm ET

NEMEP Session # 5
NEW MARKET OPPORTUNITY
  Dan Easley, CEO Encore Healthcare 

"SNF Patient Driven Groupings Model: NEW Opportunity to RESET HME Relationships ”

SNFs implemented a new reimbursement model that replaced the Resource Utilization Group (RUG-IV) rates with PDGM. RUG reimbursement focused on the amount of physical/occupational therapy minutes a patient utilized, and now PDGM focuses on a case mix formula that emphasizes patient complexity, additional comorbidities, PT/OT scores, Nursing resources, & specialized treatments including ventis. The shift to PDGM recognizes the complexity of a respiratory diagnosis & therapies required to treat patients.  Objectives:  Understand how the PDGM model recognizes respiratory therapy value & use of higher level technologies to drive improvements; How to leverage use of sophisticated RT equipment into contracted RT services at the SNF; Partnering with the SNF to insure a seamless transition into the home & to reduce readmits while improving patient outcome scores  Understand how to price respiratory services & outcome data from a pulmonary program to drive value to the SNF.