The frequency of low-utilization payment adjustments (LUPAs) increased for many home health providers in the first year of the Patient-Driven Groupings Model (PDGM), which coincided with the COVID-19 crisis. In part, that’s because there are far more LUPA variables to keep track of under the new payment model. At times, increases were also linked to […]
Despite the once-in-a-generation COVID-19 pandemic, the home health industry’s transition to the Patient-Driven Groupings Model (PDGM) was pretty seamless. Looking into the not-too-distant future, the U.S. Centers for Medicare & Medicaid Services (CMS) will now likely attempt to make modest tweaks to a handful of key areas, payment experts believe. The agency will do so […]
It’s been 48 days since the start of “no-pay RAPs” in home health care. During this time, providers have had to navigate a sea of challenges and unexpected speed bumps while adjusting to the new process. The U.S. Centers for Medicare & Medicaid Services (CMS) kicked off no-pay RAPs on Jan. 1 of this year. […]
The Patient-Driven Groupings Model (PDGM) has finally been around long enough for there to be some legitimate and meaningful data. The COVID-19 crisis has obscured some of the numbers, but the home health world is finally gaining a clearer picture on what kind of impact the new payment model has had since its Jan. 1, […]
The switch from the Prospective Payment System (PPS) to the Patient-Driven Groupings Model (PDGM) in 2020 has posed a slew of challenges for home health providers. Orders tracking is one of them. The slicing of billing periods from 60 to 30 days has raised the stakes when it comes to obtaining signed orders. During the […]
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. […]
Home health providers have been on the front lines of the COVID-19 crisis since its outset, yet a primary concern remains being left behind by legislators, whether that’s on a state or federal level. Reimbursement for telehealth services is still on the forefront of everyone’s minds. But there are less-covered issues that haunt providers as […]
In the build-up to 2020 and the Patient-Driven Groupings Model (PDGM), many home health providers began shifting their referral strategies to focus more on hospitals, skilled nursing facilities (SNFs) and other institutional sources. Generally, providers realized that patients coming from such settings likely meant more Medicare dollars under PDGM, especially when patients were also classified […]
The impact of the Patient-Driven Groupings Model (PDGM) doesn’t appear to be universal. In fact, each home health care agency’s performance under the model seems to depend on a few somewhat uncontrollable factors, new PDGM data suggests. “CMS created a model that was based on all claims nationally, but depending on where you are and […]
The Centers for Medicare & Medicaid Services (CMS) was a little bit off with some of its predictions related to the Patient-Driven Groupings Model (PDGM). At least, that’s true when it comes to the first four months of 2020, according to Strategic Healthcare Programs (SHP) data unveiled on a recent BlackTree Healthcare Consulting webinar. The […]