Welcome to the HealthPRO® Heritage Blog

What's on the Menu? Top Diagnoses for Each Clinical Grouping

Posted on: November 12, 2019

With PDGM less than 8 weeks away, it is imperative that we begin finalizing the details. One of the most important components under the new payment model is to receive an accurate primary diagnosis that falls into one of the 12 clinical groupings. We understand how critical it is to your revenue cycle to get it right the first time. And though the home health industry and our referral sources are clear that questionable encounters can no longer be used, they are tired of hearing what they CANNOT order. They are hungry to find out what IS available on the menu from which to choose, so HealthPRO® Heritage at Home developed resources for your referral sources to easily identify the top diagnoses per clinical grouping [download below].

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Tags: PDGM, Home Health Agency

Measuring Success & Emerging Trends Under PDPM

Posted on: November 7, 2019

We all survived the PDPM transition on October 1. Now what?

As the dust settles, SNFs may be wrestling with an important question: How will the industry define and measure success under PDPM & Beyond?

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Tags: snf, Patient-Driven Payment Model, PDPM

Trick or Treat? CMS Releases Final Rule for Home Health CY2020

Posted on: November 1, 2019

October 31, 2019 – As expected, CMS finalized the significant payment model change for Home Health services starting in 2020. The Patient-Driven Groupings Model (PDGM) will start with any new patient episodes on or after 01/01/2020.

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Tags: Home Health, PDGM, CMS Update 2019

Four Pillars of Success for PDGM

Posted on: October 21, 2019

With only 11 weeks left until the January 1, 2020 implementation date of PDGM, we are now into a time for final preparations. After months of education to help home health agencies prepare, execute, and succeed, we now summarize and offer what we believe will be the Four Pillars of Success under PDGM.  

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Tags: Home Health, PDGM, OASIS Assessment

Finger on the Pulse: Initial Reactions to PDPM & Updates from the Front Line

Posted on: October 15, 2019

Gut-Check Survey Results + Feedback from the PDPM Front Line
HealthPRO® Heritage launched a survey – “PDPM Gut-Check” – to capture how the industry is feeling about the new reimbursement system.  Here’s what you and your peers had to say.

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

Understanding F2F, TPE, and RCD

Posted on: October 8, 2019

With PDGM on the horizon in less than 100 days, agencies are hearing more chatter around three key areas: Face-to-Face (F2F) Encounters, Targeted Probe and Educate (TPE), and Review Choice Demonstration (RCD). All three will affect reimbursement as agencies will need to utilize best practices. Agencies must thoroughly understand the requirements of each process to sustain viability going forward.

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Tags: Home Health, PDGM

An Industry Gut-Check: What's Your PDPM Confidence Level?

Posted on: October 1, 2019

Now is the time for our industry to over-communicate!  Put your two cents in, and learn more about what your peers are thinking, feeling, and what’s keeping them up at night, too. 

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

LUPA Management: Avoiding the 4 Letter Word

Posted on: September 27, 2019

LUPA (Low Utilization Payment Adjustment), the 4 letter word that we have all been trying to avoid under the current PPS system.  Just when we thought we had it under control, CMS has decided to add a whole other level of complexity with PDGM.  The challenge to managing LUPA’s under PDGM will be two-fold; a “moving LUPA” for each 30-day payment, and the need to meticulously manage visits within each of those 30-day windows to avoid that LUPA. 

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Tags: Home Health, PDGM, CMS Update 2019, LUPA

Achieving Agency Growth Under PDGM

Posted on: September 11, 2019

With PDGM a mere 3 months away, agencies need to focus not only on preparing for the biggest change to Medicare reimbursement in 20 years, but also be diligent in developing their 2020 marketing plan to ensure successful growth. Home care is uniquely positioned as one of the lowest cost options for skilled care and is available to patients who adhere to the home bound status. One aspect that does not change with payment reform is the ongoing need for quality and value based care delivered in the home.

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Tags: Home Health, PDGM

How to Choose (and Be) a Good Strategic Partner

Posted on: August 29, 2019

Recent CMS initiatives have created an interesting dynamic in the post-acute care industry:  Providers across the care continuum are being incentivized to form strategic partnerships and hold each other accountable for delivering efficient, enhanced patient care. 

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Tags: CMS, senior living, Home Health, Skilled Therapy, Patient-Driven Payment Model, PDPM