Date Presented 04/21/2023
This research aimed to explore employment factors of OTs after patient-driven payment model (PDPM) implementation. The majority of OTs indicated changes regarding increased productivity requirements, reduced hours, pay cuts, and loss of benefits. Few OTs reported job loss.
Primary Author and Speaker: Sydney LeRoy
Additional Authors and Speakers: Makenzie Callahan, Piper Friend, Luke Lee
Contributing Authors: Maureen Mickus
PURPOSE: The Patient Driven Payment Model (PDPM) focuses on functional needs, characteristics, and goals for residents living in skilled nursing facilities (SNFs). Changes in reimbursement have had substantial implications on the employment of occupational therapists (OTs). The purpose of this research was to explore changes regarding employment, benefits, and productivity requirements of OTs.
DESIGN: Using a descriptive, cross-sectional approach, OTs provided input regarding PDPM on employment factors (n=579). Respondents were recruited to complete an anonymous online Qualtrics survey through targeted social media sites and contract rehabilitation companies. Inclusion criteria required OTs to be employed in a SNF during the implementation of PDPM in October, 2019.
METHOD: The online Qualtrics survey included items pertaining to demographics, employment, and clinical practice, presented in multiple-select format. Results were analyzed using IBM SPSS Statistics 28.0. Chi-squared tests were used to find associations between practice characteristics and employment outcomes following PDPM.
RESULTS: The majority of OTs surveyed indicated substantial changes in employment factors including increased productivity requirements (44.8%), reduced hours (40.3%), pay cuts (31.1%), and loss of benefits (14.3%). Few OTs reported job loss. Contract OTs were more likely to receive a pay cut over in-house staff (41.9% and 15.5% respectively), χ2(1) = 38.365, p<.001.
CONCLUSION: There has been a change in reported employment factors for OTs following the advent of PDPM. Reduced hours and pay cuts could have negatively affected recruitment and retention of OTs within this critical practice area. The culmination of these outcomes related to employment (increased productivity, reduced hours, and pay cuts) may influence decision making among therapists, both new graduates and others, seeking employment in SNFs.
References
Prusynski, R., Leland, N., Frogner, B., Leibbrand, C., & Mroz, T. (2021). Therapy staffing in skilled nursing facilities declined after implementation of the Patient-Driven Payment Model. J Am Med Dir Assoc, 22(10), 2201–2206. https://doi.org/10.1016/j.jamda.2021.04.005
Warren, S. & Sampson, M. (2020). ASHA Members Report Their PDPM Experiences. ASHA Lead. https://doi.org/10.1044/leader.OTP.25042020.40
McGarry, B., White, E., Resnik, L., Rahman, M., & Grabowski, D. (2021). Medicare’s new patient driven payment model resulted in reductions in therapy staffing in skilled nursing facilities. Health Affairs, 40(3). https://doi.org/10.1377/hlthaff.2020.00824
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