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CMS Watching Home Health Providers Closely Amid Shifting Therapy Strategies

Posted on: February 28, 2020

CMS issues warning to home health agencies – don’t aggressively change your therapy utilization! 

“There is no need to drastically change behavior,” says Senior Vice President of Home Health Operations David Jones. “In fact, agencies that do are at risk under the watchful eye of CMS.”

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Tags: Home Health, PDGM, Patient-Driven Grouping Model, CMS Update 2020

The Dangers of Therapy Underutilization - Part 1: The CMS Perspective

Posted on: February 18, 2020

In the past years, overutilization of therapy had been a concern for CMS as most agencies were using therapy as a driving force for reimbursement under the previous prospective payment system and had identified significant overutilization of therapy visits by as much as 30-40%. However, audits revealed that nursing visits were also over utilized along with therapy. One would assume that nursing should be equally held accountable under PDGM for patient improvements as well and not assume that they get a free pass. However, there has been no reduction in the nursing salaries, workforce, or in their allowed patients visits thus far under PDGM by most agencies. Nursing visits were never a factor contributing to reimbursement, yet are still valued as an integral contribution to a home health episode. Therapy should not be different. PDGM does eliminate therapy-visit volumes as a determining factor in calculating reimbursements, but that does not mean that the need for therapy has changed. Therapists are strategically positioned to promote, enhance, and improve a patient’s functional abilities in the realm of home health; however, there are barriers to their services because of some agency practices. This may include reduction in therapy visit utilization, frequency or restricting disciplines.

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Tags: Home Health, PDGM, Home Health Agency

How to Supercharge Your Nursing Strategy for 2020 & Beyond

Posted on: February 11, 2020

To achieve, or maintain high marks on performance outcomes – and ultimately drive census & fiscal upside – HealthPRO® Heritage suggests: Supercharge your strategy with on-the-ground support for your Nursing team. 

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Tags: Patient-Driven Payment Model, PDPM, CMS Update 2020

Measuring PDGM Success - Industry Expert Weighs In

Posted on: February 5, 2020

With one month since the PDGM transition, the industry asks, “How can we assure and measure whether our teams are successfully navigating the transition to PDGM?” Jason Sasser, PTA/CWT/CSST/ COQS, Vice President of Clinical Strategies, HealthPRO® Heritage at Home, reflects on the industry’s most pertinent questions related to PDGM best practices and how to measure success. 

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Tags: Home Health, PDGM, Patient-Driven Grouping Model, CMS Update 2020