Are You Ready to Save $132K/Year in Medicare PDPM Penalties?

We previously posted a brief look at the findings of The Total Economic Impact™ of our Skilled Nursing Solution, in a commissioned study conducted by Forrester Consulting on our behalf. We highlighted the signifcant ROI PointClickCare customers are realizing, and shared the study’s details on all the valuable time our skilled nursing solution saves nursing staff. 

But we know you likely have one very large concern that looms over every aspect of your business: the CMS Patient Driven Payment Model (PDPM). Nearly a year into life under the new model, some skilled nursing facilities are adapting to the new case-mix classification system much better than others. The study finds that the skilled nursing facilities using our solution can better track and manage resident care, so they’re meeting or beating Medicare’s readmission standards. Who wouldn’t want to reduce Medicare costs? Let’s look more closely at the challenges PDPM presents, and how these skilled nursing facilities are overcoming them, while simulataneously improving the senior care experience for their residents.

Readmissions Can Make or Break You

Under PDPM, CMS wants you to up your game when it comes to care outcomes, so fewer of your residents end up being readmitted to the hospital. As part of the new model, CMS has instituted what can be a nasty hit to your business: Medicare can withhold as much as two percent of reimbursements if a SNF has high readmission rates. The good news: Medicare pays facilities in full when they have low readmission rates, and offers added incentives up to 1.6 percent for exceptional performers.

What contributes to high readmission rates? For starters, a lack of automation and integration across the resident journey. While some of our skilled nursing customers who spoke with Forrester previously had fragmented software solutions for billing and finance, none had one single platform for collecting and managing all resident’s health documentation, from admission to medical procedures to billing. Also, with limited access to information, care providers didn’t always have the most current and accurate data regarding residents’ medical treatments and histories. 

The Right Solution Can Bring Penalties WAY Down

“We earned more than our money back.” That’s how one customer who spoke with Forrester summed up the value of choosing PointClickCare. Once the skilled nursing customers who spoke with Forrester adopted our solution, its detailed and easily accessible resident care reports helped them identify trends and monitor metrics, improving hospital readmission rates. Plus, our enhanced data exchange platform gives users more dynamic, real-time resident updates throughout the care continuum. One director of quality improvement and regulatory compliance reported, “Before, I had to go to several different places to try and find information and now, I can literally sit in my office and just in a couple of clicks, see everything.”     

By continually meeting the readmission requirements, some interviewees have recovered their entire two percent Medicare fee. Many are reinvesting this significant dividend into projects or personnel that directly impact the quality of their care outcomes.

Besides working with SNFs to implement our solution, we’ve been sharing our insights about PDPM with skilled nursing facilities for more than a year, as they planned for – and now adjust to – the PDPM model. One customer told Forrester, “The new PDPM requirement is scary and different. PointClickCare has made it a lot less scary through their webinars and updates, really helping us with the transition.” If you’re still looking for tips and answers, check out our PDPM Ultimate Survival Guide.

One More Big Takeaway: Cut Down on Nursing Staff Turnover

Before we end our blog series on this commissioned Forrester Consulting TEI study conducted on behalf of PointClickCare, we want to focus on one more topic that emerged with promising news from the SNFs interviewed: reducing the cost of nursing staff turnover. We’ll get into the details of their experience – and the money they’ve saved – in our next post. In the meantime, take a look at our skilled nursing solution. It’ll take a lot of the pain out of PDPM!