Harvard University T.H. Chan School of Public Health, Boston, MA, USA.
Brown University School of Public Health, Providence, RI, USA.
J Appl Gerontol. 2024 Jun;43(6):688-699. doi: 10.1177/07334648231223296. Epub 2024 Jan 3.
To explore skilled nursing facility (SNF) administrator retrospective perspectives on their preparation for and initial implementation of the Patient Driven Payment Model (PDPM), the new Medicare payment system for SNFs enacted on October 1, 2019. 156 interviews at 40 SNFs in eight U.S. markets were conducted and qualitatively analyzed. : Administrators retrospectively expressed feeling well-prepared for the PDPM implementation. Advance preparation focused on training staff regarding patient assessment and documentation. Administrators also recognized increased incentives for admitting patients with more complex needs and prepared accordingly. Therapy staffing reductions were concentrated in contract employees, while SNF-employed therapists were less affected. Policy makers and industry experts should consider the long-term impact of changing financial incentives through payment reform, and ensure that reimbursement best reflects the cost of providing services while prioritizing high-quality care. PDPM's effect on care quality and access to care should continue to be monitored.
为了探究熟练护理机构（SNF）管理者对其为适应 2019 年 10 月 1 日生效的新型 Medicare 支付系统——患者驱动支付模式（PDPM）所做的准备工作以及初始实施情况的回顾性观点，对美国八个市场的 40 家 SNF 中的 156 名管理者进行了访谈并进行了定性分析。管理者们回顾性地表示，他们对 PDPM 的实施准备充分。前期准备工作主要集中在培训员工进行患者评估和记录方面。此外，管理者还认识到，接收有更复杂需求的患者会带来更多的激励，因此他们也做好了相应的准备。治疗人员的减少主要集中在合同员工，而 SNF 雇佣的治疗师受影响较小。政策制定者和行业专家应考虑通过支付改革改变财务激励措施的长期影响，并确保报销最好地反映提供服务的成本，同时优先考虑高质量的护理。应继续监测 PDPM 对护理质量和获得护理的影响。
