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 […]
BlackTree Healthcare Consulting
Even before the coronavirus hit, cash flow was poised to be a problem for home health providers in 2020. The Patient-Driven Groupings Model (PDGM) shortened home health billing periods from 60 days to 30, creating a cash flow crunch for agencies during their first few months under the new model, which took effect Jan. 1. […]
In the first three months of the year when home health agencies were adjusting to the Patient-Driven Groupings Model (PDGM), the national low-utilization payment adjustment (LUPA) rate hit 9.5%. LUPA rates reached their height in March, when the coronavirus took the U.S. by storm. Those were just a couple key takeaways from a BlackTree Healthcare […]
Medicare-certified home health agencies have now had over a full quarter to adapt to the Patient-Driven Groupings Model (PDGM). While comprehensive claims data is still coming in, a few interesting patterns are already starting to emerge. Among the high-level takeaways, case mixes appeared to be higher during the first quarter than what the U.S. Centers […]
Both during and after the COVID-19 crisis, success will favor the innovators. Providers that can adjust their business operations accordingly and keep up with the sweeping regulatory changes will have a massive advantage moving forward. Conversely, those resistant to the new, post-coronavirus normal run the risk of being left behind. “The easy prediction is that […]
The Patient-Driven Groupings Model (PDGM) was one of the largest concerns for the home health industry after it was finalized by the Centers for Medicare & Medicaid Services (CMS) in October 2019. But now that it has been implemented and agencies have faced their boogeyman, confidence under the new payment model is growing, industry insiders […]
Under the Patient-Driven Groupings Model (PDGM), 80% of home health agencies are experiencing a difference in reimbursement compared to the old Prospective Payment System (PPS). Of those, the vast majority — 82% — are experiencing a decrease in reimbursement. That’s according to a recent survey of 127 home health agencies conducted by information technology firm […]
The long-awaited Patient-Driven Groupings Model (PDGM) is finally here, marking the biggest home health reimbursement overhaul in two decades. PDGM officially launched on Jan. 1 after originally being proposed by the Centers for Medicare & Medicaid Services (CMS) in July 2018. With changes to billing periods, therapy reimbursement and LUPAs, it’s the most significant shift […]
The Patient-Driven Groupings Model (PDGM) is still months away, but its projected impact on therapy utilization is already sending shockwaves throughout the home health industry. With an eye toward 2020, many providers anticipate cutting back on therapy and shifting their business models more toward nursing services, especially when it comes to higher-paying areas such as […]
After federal health care policymakers fine-tuned the Patient-Driven Groupings Model (PDGM) last October with a 6.42% cut based on certain behavioral assumptions, some industry experts predicted there would be a modest uptick in home health bankruptcies in 2020. “The last time the industry went through this kind of major change was in the late 1990s […]
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