This Critical Combo Could ‘Blow Up’ Home Health Agency Revenue Cycles

The Review Choice Demonstration (RCD) for Illinois home health agencies started on Saturday, with more than three-quarters of providers taking the pre-claim review route. For the most part, affected agencies have expressed confidence moving forward under RCD, an initiative from the Centers for Medicare & Medicaid Services (CMS) meant to curb improper billing. The bigger […]

VNSNY Chief of Provider Services: Home Health Disruption Isn’t ‘an Atomic Bomb’

One of the oldest nonprofit home- and community-based health care organizations in the country is counting on innovative technology and reimbursement models to keep it on the cutting edge in the years to come. As such, preparing for the Patient-Driven Groupings Model (PDGM), pursuing risk-based relationships and exploring predictive analytics are top of mind for […]

Amedisys Execs Share Action Plan for ‘Worst Form’ of PDGM

Despite being one of the largest and most powerful home health companies in the game, Amedisys Inc. (Nasdaq: AMED) isn’t immune to the uncertainty that comes with the looming Patient-Driven Groupings Model (PDGM). The Baton Rouge, Louisiana-based provider has a plan of action, even if the model goes into effect on Jan. 1 as is […]

PDGM Unlikely to be Delayed; Coders Next Home Health ‘Rock Stars’

Despite tenacious rumors, home health owners and operators shouldn’t hold their breath that the Patient-Driven Groupings Model (PDGM) is going to be delayed. All signs still point to a Jan. 1, 2020, implementation date, J’non Griffin, president of full-service consulting company Home Health Solutions LLC told Home Health Care News. “I can’t say definitively because […]

PDGM’s Co-Morbidity Changes May Trigger Substantial Payment Bump

To fine-tune operations ahead of the Patient-Driven Groupings Model (PDGM) with the hopes of maximizing reimbursement, many home health providers have shifted their referral focus to institutional settings. But there are also substantial dollars tied to patients’ co-morbidities, an idea that has largely fallen by the wayside when it comes to PDGM preparation. “It’s somewhat […]

Encompass Health’s April Anthony: PDGM Is an ‘Overcorrection’ to Therapy

As currently structured, the Patient-Driven Groupings Model (PDGM) will completely change how and when home health providers deliver therapy services. It will do so in multiple ways, most notably by eliminating the use of therapy service thresholds as a factor in payment determinations. It’s a move the Medicare Payment Advisory Commission (MedPAC) has long recommended. […]

Home Health Clinicians Face PDGM Knowledge Gap

The vast majority of home health clinicians currently face a steep uphill climb when it comes to operationalizing the Patient-Driven Groupings Model (PDGM), with slightly less than eight months to go before the payment overhaul goes live, a new survey suggests. Among its changes, PDGM uses 30-day periods as a basis for payment, with each […]

House Lawmakers Move to Scrap PDGM’s Widely Opposed Behavioral Assumptions

The home health industry won a major victory in its battle to scrap widely opposed provisions of the Patient-Driven Groupings Model (PDGM) Wednesday, as a group of bipartisan House lawmakers introduced a new bill targeting the payment overhaul’s behavioral assumptions. Introduced by Reps. Terri Sewell (D-Ala.), Vern Buchanan (R-Fla.) and Ralph Abraham (R-La.) — along […]