Debunking Common PDGM Primary Diagnosis Myths

In order for home health providers to see reimbursement success, they need to be able to separate myths from facts when it comes to the Patient-Driven Groupings Model (PDGM). But one specific point of confusion has been primary diagnosis clinical groups. “There are a lot of rumors and myths floating around out there,” Robbi D. […]

More Than Half of All Home Health Agencies Have Treated COVID-19 Patients

The U.S. Centers for Medicare & Medicaid Services (CMS) officially closed its public comment window for the 2021 proposed home health payment rule on Monday. Unlike the past couple of years, the latest proposed payment rule included relatively minor changes and rate adjustments for the year ahead. In light of the mild proposal, CMS only […]

Home Health Care’s ‘Pandemic Pioneer’ Grows Patient Census to All-Time High

EvergreenHealth Home Care — one of the largest home health and hospice providers in the Pacific Northwest — is the home health industry’s “pandemic pioneer.” Affiliated with a local hospital based just outside of Seattle, EvergreenHealth Home Care began caring for its first COVID-19 patients toward the end of February, several weeks before many of […]

Amedisys Expands Personal Care Network Through New Partnership with BrightStar Care

One of the largest home care franchises in the country is teaming up with one of the nation’s largest home health providers. Chicago-based BrightStar Care signed a care coordination agreement with Baton Rouge, Louisiana-based Amedisys Inc. (Nasdaq: AMED), adding BrightStar’s agencies to Amedisys’ personal care network. The personal care network’s goal is to facilitate care […]

Senator Kirsten Gillibrand Pushes for Increased PPE, Telehealth Payment for In-Home Care Providers

U.S. Senator Kirsten Gillibrand (D-Ny.) is asking the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to ensure that in-home care providers have access to essential resources amid the coronavirus.   Throughout the public health emergency, home health and home care providers have been vocal about the challenges […]

CMS Announces New ‘Phased-In Approach’ to the Review Choice Demonstration

The U.S. Centers for Medicare & Medicaid Services (CMS) announced Friday it will not resume a full-blown resumption of the Review Choice Demonstration (RCD) for home health agencies in participating states later this month. Instead, CMS is “phasing in” RCD for agencies in North Carolina and Florida. Agencies in Illinois, Ohio and Texas will be […]

Home Health Agencies Aren’t ‘Upcoding’ to Maximize PDGM Reimbursement

In designing the Patient-Driven Groupings Model (PDGM), officials from the U.S. Centers for Medicare & Medicaid Services (CMS) made a handful of assumptions about how Medicare-certified home health operators would respond once the overhaul went live. Among those assumptions, CMS believed home health agencies would automatically “upcode,” or pick the primary diagnosis code tied to […]