The DOs and DON’Ts when signing a PDPM Pricing Amendment

DO

  • Options – PDPM is not “one size fits all”, ask for 2 to 3 pricing options from your therapy provider so you can choose the one that you think is best for your facility.

  • Simplicity – You should be able to clearly understand what it is you are paying.

  • Flexibility – Many therapy providers have extensive knowledge of PDPM, no therapy provider has ever implemented PDPM. We have modeled and “hypothesized” what it would look like. Your contract should have an option to review PDPM pricing in 3 to 6 months. This is the only way both the SNF and the therapy provider can ensure their contract is working for both parties.

  • MPPR – Make sure your Medicare Part B services contract has this acronym. IF it does not, there is a strong possibility you are paying more for this service than you are getting reimbursed.

DON’T

  • A Contract Extension! – Many Therapy Providers are taking this opportunity to slip in a “non-cancellable” 12-month or 24-month contract extension into this PDPM Payment Amendment. So if you current provider is not as good at PDPM as you had hoped, you are stuck with them for a year or more?! They now get to practice PDPM for a year or two at your expense…… That makes NO SENSE for the SNF, but does make a lot of sense for the Therapy Company that is not confident in their PDPM ability and/or knowledge).

DO NOT DO IT! Just say “No”