Beyond Therapy: How Specialty Physicians Can Drive PDPM Medicaid Success
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Beyond Therapy: How Specialty Physicians Can Drive PDPM Medicaid Success
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As more states transition to PDPM for Medicaid, therapy is no longer the primary driver of case mix index (CMI). So where do providers turn next?
In this episode, Melissa Brown, COO of Gravity Healthcare Consulting, sits down with Dr. Rehan Shah, nephrologist and co-founder of CardioRenal Vision (CRV), to explore how cardiology, nephrology, and pulmonology services can transform PDPM Medicaid outcomes.
Together, they discuss:
- Why therapy-driven CMIs are declining under PDPM Medicaid
- How specialty physician programs improve documentation, acuity capture, and reimbursement accuracy
- The power of on-site care models—from dialysis to respiratory therapy—to reduce hospitalizations and boost CMI
- Practical steps for aligning physicians, MDS coordinators, and facility leadership
If your organization is preparing for PDPM Medicaid—or already navigating the transition—this episode offers actionable insights to help you strengthen performance, accuracy, and margins under the new model.
🎧 Hosted by: Melissa Brown, COO, Gravity Healthcare Consulting
📍 Guest: Dr. Rehan Shah, Co-Founder, CardioRenal Vision
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