Welcome to the HealthPRO® Heritage Blog

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, Patient-Driven Grouping Model

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

Will You Sink or Swim in PDGM? Care Pathways to Success

Posted on: August 28, 2019

Is your current therapy company or in-house therapy team equipped to help you prepare, execute and succeed under PDGM?

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

Intake Isn't Just Intake Anymore: Important Steps in PDGM Referral Processing

Posted on: August 13, 2019

Five, ten, and fifteen years ago, the intake department was just that: Intake. Taking in the information given to them from a referral source and performing the necessary data entry. As we prepare for the new world of PDGM, the Intake Department will be an integral part of the team.

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Tags: Home Health, PDGM, Patient-Driven Grouping Model

The Only Constant is Change...and Documentation

Posted on: August 7, 2019

The Home Health industry continues to evolve: the updated Conditions of Participation (CoPs) in 2018, then OASIS-D and the Review Choice Demonstration (RCD) in 2019, and now the Patient-Driven Groupings Model scheduled for 2020, just to name a few!  Change can be exhausting, so it is comforting to know that some things aren’t changing...like documentation!

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Tags: Home Health, PDGM, CMS Update 2019

Ticket to Ride: OASIS Will Drive Success Under PDGM

Posted on: April 30, 2019

Accurate OASIS coding has always been important, but with PDGM on the horizon, our ability to master the OASIS will be imperative! After all, accurate OASIS coding will directly impact an agency’s ability to achieve optimal outcomes and support reimbursement in today’s and tomorrow’s world.

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

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

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

Home Health Providers: Leverage QAPI Plan to Prep for PDGM?

Posted on: October 1, 2018

In the recently updated Conditions of Participation, CMS spells out what they expect from a QAPI program. Additionally, the final draft of the interpretive guidelines (IG) for the Home Health Agency Conditions of Participation (CoP) was released last month.

How can agencies use this already mandatory requirement to help prepare them for the expected changes coming in 2020 with the proposed Patient Driven Groupings Model (PDGM)?

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Tags: Home Health, QAPI Plan, PDGM

From PDPM to PDGM: Home Health in the Hot Seat

Posted on: August 30, 2018

How Will the Recent Home Health Proposed Rule Affect the PAC Industry?

NOW WHAT?
PDGM (Patient-Driven Groupings Model) was recently announced in July as part of the Proposed Rule published by CMS and is anticipated to be THE biggest change in home health reimbursement 20+ years!

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Tags: Home Health, CMS Update 2018, PDGM