Top PDGM Therapy Myths Busted

With the implementation of the Patient-Driven Groupings Model (PDGM) just months away, therapy-heavy providers are still trying to determine what the payment overhaul will mean for them. With the uncertainty comes misconceptions, which can end up hurting a provider’s bottom line if taken to heart. One of the biggest myths associated with PDGM is that […]

Therapy Survival Tips for PDGM

With the Patient-Driven Groupings Model (PDGM) set to move home health payment away from existing therapy thresholds and toward patient characteristics in 2020, providers will need to break down silos within their own operations if they want to be successful. Generally, many providers have often relied on a therapy-driven model, which has been a big […]

CMS’s Proposal to Eliminate RAPs, Increase PDGM’s Behavioral Adjustment ‘Death by 1,000 Cuts’

Home health operators and industry advocates are voicing their concerns following a proposal from the Centers for Medicare & Medicaid Services (CMS) to eliminate home health pre-payments and move forward with behavioral assumptions under the Patient-Driven Groupings Model (PDGM). Specifically, many worry the proposed changes will create cash flow problems for home health agencies, which […]

Nearly Half of Home Health Providers Expect to Decrease Therapy Utilization Under PDGM

Nearly half of home health providers anticipate decreasing their therapy utilization in 2020 in response to the Patient-Driven Groupings Model (PDGM), a payment overhaul from the Centers for Medicare & Medicaid Services (CMS) that is partially designed to refocus the industry toward nursing. Among its changes, PDGM shifts home health payment away from existing therapy […]

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 […]

Why Functional Status Matters More Under PDGM

The Patient-Driven Groupings Model (PDGM) will shake up how and when home health providers are reimbursed compared to the current Medicare model, which has been in place since 2000. Among PDGM’s changes, for example, functional status and the OASIS M1800s section will matter significantly more. That’s a major change for home health providers, who are […]