Tag: PDGM
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1 November 2019 - 14:20, by , in Blog, Post Acute, Comments off
CMS issued the CY 2020 Home Health Prospective Payment System Rate Update, which finalized changes for PDGM. In the final rule, the behavioral adjustment has been lowered to 4.36%.
31 May 2019 - 11:25, by , in Blog, Post Acute, Comments off
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.
cash flow maintenance
2 October 2019 - 11:56, by , in Blog, Post Acute, Comments off
Learn the three strategies for preventing a loss or delay in cash flow due to the significant changes under PDGM.
9 July 2019 - 16:24, by , in Blog, Post Acute, Comments off
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 Clinical Coding Challenges
3 April 2019 - 14:46, by , in Blog, Post Acute, Comments off
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.
PDGM Clinical Coding Challenges
6 March 2019 - 11:58, by , in Blog, Post Acute, Comments off
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...
16 January 2019 - 17:36, by , in Post Acute, Comments off
The Patient-Driven Groupings Model (PDGM), is the most significant change to the home health payment reform in the past 20 years. PDGM completely alters the methodology for calculating payments, and an example of this is the removal of therapy utilization as a component and the payment periods have been reduced from 60 to 30-days...
18 December 2018 - 11:40, by , in Case Studies, Case Studies, by Market, Comments off
The home care provider was experiencing a high LUPA rates that consistently exceeded 15%. A staffing shortage, particularly with nurses, combined with communication challenges throughout made it difficult to achieve positive patient outcomes.
PDGM Compliance Risk Areas
25 September 2018 - 10:06, by , in Blog, Compliance, Comments off
More than any of the very complex modifications contained in the Patient-Driven Groupings Model, the most important enhancements emphasize the dire need for all agencies to have a solid and well-functioning episode management program in place before January 1, 2020.
Magnifying Glass
12 July 2018 - 9:01, by , in Blog, Post Acute, Comments off
The proposed home health groupings model (HHGM) has resurfaced in an updated form—the Patient-Driven Groupings Model (PDGM).