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 […]