PDPM Boosts Medicare Rate 9% Early in COVID-19 Crisis: ‘RUGS-IV Would Have Been a Fiscal Disaster’

Ken BellCORE AnalyticsLeave a Comment

Skilled nursing facilities received a 9% Medicare reimbursement boost during the early days of the COVID-19 crisis under the new Patient-Driven Patient Model, a new analysis has determined — providing a crucial fiscal lifeline that may not have existed under the structure that PDPM replaced.

“RUG-IV would have been a fiscal disaster for SNFs dealing with COVID,” Zimmet Healthcare Services Group and affiliated data firm CORE Analytics concluded in a new report released last week.

The New Jersey-based Zimmet and CORE drew on Medicare claims submitted by the more than 1,300 SNFs that submit data to its proprietary CORE database.

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