Patient-Driven Groupings Model
The new system of Medicare payment system that started to be implemented in early 2020 has been associated with several drawbacks. The Patient-Driven Groupings Model focuses more on the patient’s pathological conditions to reimburse care (Gardner, 2019). The system opposes the traditional way of reimbursing care based on the number of therapy minutes the patient required. Cries of lack of reimbursement have been heard since the model was implemented for the first time.
One of the significant drawbacks of the Patient-Driven Groupings Model is that it discourages the provision of speech-language treatment that was common in the previous systems. Most speech-language health providers have been forced to change the way they carry out their practices significantly. According to Schaum (2020), staffing levels are also likely to be considerably affected (Schaum, 2020). The elimination of a separate payment for speech-language in the current system is expected to cause significant challenges in the provision of home care. It appears that Medicare expects that patients will be treated holistically regardless of whether or not the process will require payments for specific therapies.
PDGM eliminates extra visits for therapy and allocates money based on a patient’s pathological characteristics. That factor has called for shifts in responsibilities, roles, and staffing levels (Schaum, 2020). The impacts of the new model appear to be similar to another payment mode that was implemented on 1st Oct 2019, which was associated with several adverse changes. The most significant was the significant reduction in salaries and layoffs (Schaum, 2020). There were transitions from full-time to part-time positions. The number of working hours was also significantly reduced.
References
Gardner, K. (2019). Home Health Patient-Driven Groupings Model (PDGM).
Schaum, K. D. (2020). Impact of the New Home Health Agency Payment System on Wound/Ulcer Management. Advances in Skin & Wound Care, 33(2), 65-67.