AJMC® in the Press, April 3, 2020

An article by Skilled Nursing News, titled “Researchers Find ‘Perverse Incentives’ for Skilled Nursing Operators Under PDPM,” cited a study published in the April 2020 issue of The American Journal of Managed Care^® (AJMC^®) titled “The Patient-Driven Payment Model: Addressing Perverse Incentives, Creating New Ones.” In the study, researchers indicated that although the Patient-Driven Payment Model (PDPM) addresses perverse incentives in Medicare’s previous payment system for skilled nursing facilities (SNFs), it includes new incentives that may be problematic. The study authors recommended that regulators should maintain close oversight of billing by SNFs and patient outcomes as the PDPM takes effect to mitigate potential unintended consequences.

A piece reported by Healio referenced a study published in the November 2019 issue of AJMC^®, “CKD Quality Improvement Intervention With PCMH Integration: Health Plan Results.” The study results supported innovation in chronic kidney disease (CKD) by commercial health plans, as a scalable CKD quality improvement intervention demonstrated feasibility, decreased hospitalization, and reduced costs.