Change in Medicare Reimbursement Medicare implemented a Case Mix Reimbursement i

Change in Medicare Reimbursement
Medicare implemented a Case Mix Reimbursement in response to the Nursing Home Reform Act. For many years, the Resources Utilization Groups (RUGs) was the system used. CMS dramatically revised RUGs in 2019. They created a new system: Patient Driven Payment Model (PDPM). These changes have a significant impact on nursing homes.
As you learned with Chapter Six (Financing and Reimbursement), Medicare plays a significant role in nursing home fiscal viability. Most nursing homes lose money from Medicaid reimbursement. Medicare is profitable but limited given Medicare coverage rules. Nonetheless, changes in Medicare reimbursement are very important to nursing homes.
The material that describes PDPM and the changes to Medicare Reimbursement can be found in the Week Three and Four subfolder (Finance and Reimbursement), located in the Week-by-Week Folder.
You are required to submit a page, up to three pages paper. Your goal is to:
•Define, describe, explain the PDPM reimbursement system
•Identify important differences between PDPM and RUGs 4
•Define and describe how PDPM impact nursing homes. Consider
◦Who is admitted?
◦How does this create and opportunity or threat to a facility?
◦How does this impact operations?
Students should use the sources in this folder along with the text as needed. Your paper should not exceed two pages: a main idea (first sentence), topic sentences that explain your main idea (first sentence in each paragraph) and organized support sentences. Source and cite the videos properly (you will lose points if you write according to the video) Proper sourcing and referencing is required for all material that are used.
YouTube Video Sources :