As skilled nursing providers stare down a new Medicare payment system and macro-level moves toward value-based care, the pressures at first could seem insurmountable due to several factors at work.
- The Patient-Driven Payment Model (PDPM) will upend the Medicare reimbursement system.
- State-level Medicaid issues will continue to strain long-term care providers.
- The rise of other new payment models — including accountable care organizations, bundled payments, and value-based purchasing — will make operators’ daily lives a swirl of competing incentives and the constant potential to lose out on vital reimbursement dollars.
- Pressure from health systems to deliver high quality care at the lowest cost possible, treating patients in place unless absolutely necessary to send to the hospital.