2:45-3:45 p.m

75-B. From Minutes to Medicine: Protecting Your Reimbursement

Medicaid's Patient-Driven Payment Model (PDPM) has shifted reimbursement away from therapy minutes and toward documented clinical complexity. As a result, many organizations are seeing their Case Mix Index decline and Medicaid rates compress because resident acuity, the model's focus, is not fully documented in the record or captured in the Minimum Data Set (MDS). This session offers a practical playbook to restore payment accuracy and audit defensibility by replacing "minutes" with "medicine." A healthcare consultant will recommend engaging specialty physicians to confirm active diagnoses, document how conditions affect daily care, and classify diseases to improve MDS precision. You'll discover ways to protect reimbursement while improving care for complex, long-stay residents.

• Melissa Brown, Chief Operating Officer, Gravity Healthcare Consulting — Cumberland, MD, United States