Counterpoint: Elimination of RAPs Isn’t a ‘Sky-Is-Falling Issue’

Since the Centers for Medicare & Medicaid Services (CMS) announced its proposal to phase out Requests for Anticipated Payments (RAPs) last month, home health providers have voiced their concerns about what the change will mean for them. Industry-wide, the consensus isn’t good. Many providers worry the removal of RAPs, in addition to the other regulatory […]

CMS Finding New Ways to Penalize Home Health Providers

The Centers for Medicare & Medicaid Services (CMS) is finding new ways to penalize home health providers. In its proposed payment rule for 2020 released last week, CMS floated the idea of phasing out pre-payments for home health services starting in 2020, killing them completely by the following year. Currently, home health providers can receive […]

Beating the Buzzer: Why Timing Is Everything Under PDGM

While timing tweaks haven’t received quite the attention therapy and coding changes have ahead of the Patient-Driven Groupings Model (PDGM), beating the buzzer will be more important than ever for home health agencies when the new model takes effect. For example, the Centers for Medicare & Medicaid Services (CMS) will pay higher reimbursement rates for […]

Creative PDGM Therapy Strategies for Home Health Agencies

When the Patient-Driven Groupings Model (PDGM) takes effect on Jan. 1, 2020, therapy-heavy home health agencies will have to get creative to ensure the new model doesn’t hurt their bottom line. PDGM eliminates therapy-visit volume as a determining factor in calculating reimbursements, meaning therapy will no longer be a guaranteed revenue-driver for home health agencies. […]

Credit, Billing Staff Are Keys to a Smooth Financial Transition into PDGM

When the Patient-Driven Groupings Model (PDGM) takes effect Jan. 1, home health care billing processes will become significantly more complicated. The new model revolutionizes the way agencies are reimbursed, cutting payment periods in half and requiring more detailed claims, among other changes. As a result, PDGM will likely put financial strain on even the most […]

How Telehealth Can Solve Home Health Agencies’ PDGM Therapy Problems

One of the most anxiously awaited aspects of the Patient-Driven Groupings Model (PDGM) is the elimination of therapy visit volume as a determining factor in calculating reimbursements. Despite reassurance from industry leaders that PDGM isn’t a ‘death knell’ for therapy services, therapy-heavy agencies will have to become more cost effective to ensure they don’t take […]

Cash Flow, Timing and Other Practical FAQs About PDGM Answered

There are just nine months to go before the implementation of the Patient-Driven Groupings Model (PDGM), but many home health care agency owners and operators remain uncertain about what the looming payment overhaul will mean for them. On a macro level, all home health agencies are waiting to find out if reimbursement changes will ultimately […]

Primary Diagnosis Changes Among PDGM’s Most Overlooked Aspects

The Patient-Driven Groupings Model (PDGM) is just nine months from taking the home health care industry by storm. By now, operators should have started preparing for the sweeping adjustments on tap for 2020 — but taking the right steps at the right time is crucial to ensuring success. Among its high-level changes, PDGM removes perceived […]