PDGM – Resources & Insights
Welcome to McBee’s PDGM resources and insights. Below is your full access to need-to-know resources to help you adapt and adjust to the new reimbursement model.
Without a doubt, the Patient-Driven Groupings Model (PDGM) is the largest home health regulatory challenge facing the industry. It is the most far-reaching Medicare payment rule since the initiation of the Home Health Prospective Payment System (HHPPS) in 2000, and will significantly impact the way home health agencies operate.
We’re here to help you win under PDGM by providing the resources you need to successfully transition while continuing to provide the most effective, quality care to patients.
WEBINARS | eBOOK | McB INSIGHTS | PDGM Market Data | VIDEOS
Our webinars will take insights gleaned from working alongside the full continuum of care, advocating change in proposed regulations, and partnering with industry organizations and associations to keep you informed with the most current and relevant information on PDGM.
PDGM: Patient-Centered Care Plans and Effective Utilization Management
Efficient and high-quality care delivery is more important than ever with the implementation of PDGM. Providers must now manage shorter 30-day payment periods, contend with unique LUPA thresholds based on case-mix group assignment, and adjust to the removal of therapy thresholds as a payment driver.
Clinical Leadership Development and Care Coordination Under PDGM
PDGM introduces complex challenges and heightens the importance of efficient discipline utilization while maintaining quality care outcomes. The role that the clinical manager plays in this care management process can make or break success under the new model.
OASIS in a PDGM World – The Clinical Perspective
The patient’s functional level is one of five categories affecting payment in the Patient-Driven Groupings Model (PDGM), making the role of the clinician critical for OASIS scoring in determining the functional impairment level. This webinar will discuss OASIS data collection as it relates to the 30-day payment period and case-mix calculation.
Leverage Revenue Cycle Key Performance Indicators for Home Health Care Success
Understanding what your revenue cycle metrics are telling you about your operations is crucial to running a streamlined home health agency. This webinar will detail the core Key Performance Indicators (KPIs) used in the home health industry and help you better understand what these metrics are telling you about your operations currently and under PDGM.
Diagnosis Coding in a PDGM World – The Clinical Perspective
PDGM is the most significant change for diagnosis coding since the implementation of ICD-10. A key component for calculating payment under PDGM will be clinical group assignment and comorbidity adjustment, thus making accurate ICD-10 coding more important than ever.
Episode Management in a PDGM World
This webinar provides an overview of the core elements of the PDGM rule and the key clinical and operational concepts that make up an effective episode management program under the new model. Listen to this webinar to identify episode management strategies within key segments of a patient’s episode and learn the heightened importance of efficient patient visit/clinical discipline utilization.
Keep up on the latest industry trends and insights with our blogs and case study detailing the clinical, financial, and operational impacts of PDGM.
2020 Medicare Final Rule Released, PDGM Finalized
CMS issued the CY 2020 Home Health Prospective Payment System Rate Update, which finalized changes for the Patient-Driven Groupings Model (PDGM) that will go into effect on January 1, 2020.
Three Cash Collection Strategies to Prioritize for PDGM
As the Patient-Driven Groupings Model (PDGM) is approaching, organizations are currently focusing on how it will impact revenue cycle functions. To prepare financially prior to PDGM’s implementation date of January 1, 2020, home health organizations can focus on cash collections to be prepared for any loss or delay in cash flow due to the significant changes under the new model and identify risks that could cause potential delays across the revenue cycle.
PDGM: Expedite Turnaround to Bill Accurate Claims by Optimizing Order Management Process
Home health organizations depend on their staff and tracking systems for a quick and efficient order management process. Order management is a key component within the revenue cycle process, as the collection of physician documentation is required to initiate any billing process. A bill cannot be generated without first obtaining all necessary orders.
PDGM: Tackling Referral and Intake Complexities with Change Management
For home health organizations, referral and intake directly impact an agencies core operations and ability to provide appropriate care and bill in a timely manner. PDGM adds a new layer of complexity to this process by introducing the 30-day billing periods and admission source.
Critical Steps Every Agency Should Take to Transition LUPAs to PDGM
In the 2020 Patient-Driven Groupings Model (PDGM) environment, LUPAs will become even more complicated with the introduction of the multifaceted structure of visit requirement variables. Like so many other aspects of PDGM, this change in calculation requires your attention.
Patient Driven Groupings Model (PDGM) Readiness Series: Clinical Coding Challenges
The Patient-Driven Groupings Model (PDGM) is the most significant change to the home health payment reform in the past two decades. The impact from PDGM is expected to significantly shift service delivery and will change the structure of home health reimbursements. A key component for calculating payment under PDGM...
We’re committed to giving you the most valuable resources to ensure success in the ever-changing healthcare landscape. With our PDGM Market Data & Analytics, we’ve taken a deeper dive into claims data and have prepared robust dashboards that highlight some of the most important data to leverage for success under PDGM.
Learn more about our PDGM Market Data & Analytics.
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With all the changes PDGM brings, it can be overwhelming knowing where to start preparing your agency and developing an action plan. If you have any questions or want more information about the transition to PDGM, please contact us at 610.964.9680 or fill out the form below and our experts will be in touch shortly to help you with all your PDGM needs!