Welcome to the HealthPRO® Heritage Blog

Get Ready for PDGM

Posted on: April 25, 2019

Implementation of the new case-mix classification model, the Patient Driven Grouping Model (PDGM), on January 1, 2020 will bring BIG changes to the home health profession! HealthPRO® Heritage at Home is ready to help you start preparing TODAY for the most dramatic Medicare reimbursement change since PPS.

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Tags: Home Health, PDGM, CMS Update 2019, Revenue, Patient-Driven Grouping Model, PrepareExecuteSucceed, OASIS

Update from CMS Regarding Group/Concurrent Under PDPM • April 19, 2019

Posted on: April 20, 2019

Late Friday afternoon, April 19, CMS released the FY 2020 SNF PPS Proposed Rule, specifying a few changes for the Patient-Driven Payment Model (PDPM). HealthPRO® Heritage is looking forward to reporting out on all the modifications, but can’t wait to share the following good news…

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Tags: Payment Reform, Patient-Driven Payment Model, PDPM, CMS Update 2019

QRP and QMs are Changing with the Times. Are You?

Posted on: April 18, 2019

As of April, CMS has implemented important modifications for the Quality Reporting Program (QRP) and Quality Measures (QMs) that may have significant fiscal, clinical, and compliance implications as well. Not only will these changes enable CMS to better monitor SNF outcomes, the modifications raise the bar on performance measures and will challenge SNFs to drive care differently. 

What should SNFs know?  HealthPRO® Heritage offers guidance. 

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Tags: Patient-Driven Payment Model, PDPM, CMS Update 2019

Under PDGM: Revenue Cycle Matters

Posted on: April 15, 2019

PDGM implementation is a mere 38 weeks away, bringing significant changes in episode length (60 to 30 days), resultant billing processes, revenue cycle, and ultimately, cash flow. While certification periods will continue to be 60 days in duration, reimbursement will be broken into 30-day payment periods. As such, billing will have to be processed for each 30-day payment period including Requests for Anticipated Payment (RAPs) and final claims. This will likely result in a substantial increase in claims volume in addition to an interruption in cash flow. Specifically, agencies will experience a cash flow “crunch” during the first few months of implementation as the conversion from 60-day to 30-day payments is realized with a leveling off after the initial impact and conversion.

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Tags: Home Health, PDGM, Revenue, Patient-Driven Grouping Model, PrepareExecuteSucceed, Episode Length of Stay, ELOS

Group Therapy Under PDPM: Strength in Numbers

Posted on: April 11, 2019

Think about a task you routinely complete:  yardwork, cooking a meal, or a project at work.  Now imagine asking a friend or co-worker to pick up a rake or join you in the kitchen.  Your results:  being able to complete the same tasks with improved efficiency and even better outcomes.    

Apply this thought-process to providing world-class rehab services for the patients in your care.  Research supports:  There’s strength in numbers!

The post-acute world is looking forward to new rules. Learn more about best practices and potential pitfalls RE: Group Therapy Under PDPM. 

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Tags: Patient-Driven Payment Model, PDPM

Facts about Occupational Therapy

Posted on: April 2, 2019

April is OT Month... Here are some interesting facts.

The U.S. Bureau of Labor Statistics calls occupational therapy one of today's fastest growing careers, pointing to growing numbers of older adults and young children who need occupational therapy services.

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Tags: Occupational Therapist, #OTMonth, occupational therapy

Give a Little to Get a Lot: Nursing, PDPM, and Documentation ReDesign

Posted on: April 1, 2019

CEOs, NHAs, and DONs take note!  With the new PDPM paradigm, you’ll be asking your nurses to:

  • Continue to drive quality measures, star ratings, survey results, satisfaction scores, etc.
  • Care for higher acuity patients; and
  • Adopt very different documentation practices.

All of these requisites are vitally important to your facility’s success under PDPM. But perhaps the most challenging change for Nursing teams (who really just want to be patient caretakers, right?) will be #3 on this list. 

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Tags: CMS, CMS policy, Payment Reform, Patient-Driven Payment Model, PDPM, CMS Update 2019

HealthPRO Heritage Compliance Coordinator Berenice Galvez-Soto named to Rising Star Class of 2019 by McKnight's

Posted on: March 22, 2019

Chicago, IL March 22, 2019 – HealthPRO® Heritage, one of the largest independently owned therapy and consulting service providers in the country, is proud to announce that its Quality Assurance Compliance Coordinator Berenice Galvez Soto was named to the inaugural class of Rising Stars in the McKnight’s Women of Distinction program.

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Tags: Compliance

Keep Calm & ICD-10 Code On

Posted on: March 21, 2019

PDGM implementation is a mere 42 weeks away and is anticipated to be the biggest change in home health payment reform in over 20 years. HHAs will need to completely revise care management and billing processes, as well as documentation and coding practices, in order to make the transition successfully. One of the most dramatic areas of change relates to ICD-10 coding, which is a significant determinant of revenue in the new paradigm. Both timing and accuracy of ICD-10 Coding (primary diagnosis and comorbidities) will play a role in how patients are grouped and, ultimately, reimbursed. Given that this is a completely new core competency for HHAs, it is prudent to take action today to assess related risk and begin to identify the changes that will need to occur in order to minimize transition risk.

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Tags: PDGM

Legal-Ease: A Collaborative Approach to Therapy Contracts Under PDPM

Posted on: March 21, 2019

Check back here in the upcoming weeks for this blog post.  In the interim, please contact us for specific inquiries related to PDPM contracting at info@healthpro-heritage.com.

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Tags: PDPM, Therapy Contracts