Welcome to the HealthPRO® Heritage Blog

OASIS-D1: Who, What, When, and Why

Posted on: January 7, 2020

The Patient-Driven Grouping Model (PDGM) is almost one week underway! In order to assist with the transition to PDGM, CMS has updated OASIS data collection. These revisions include the addition of two new items and change twenty-three existing items as optional at some OASIS time points. Let’s breakdown the changes. 

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

PDGM Eve and 2019 in Review

Posted on: December 31, 2019

PDGM Implementation is Tomorrow! 
In 2019, we've published extensive break-downs of the things you may need to know about therapy in Home Health Agencies and Senior Living facilities. 

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

For Outcomes Excellence Under PDGM, Embrace Therapy

Posted on: December 19, 2019

Inclusion of therapy in an interdisciplinary care plan under PDGM represents one of the greatest opportunities to impact patient outcomes and patient satisfaction.

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Tags: Home Health, PDGM

Under PDGM: Add Up the Benefits of Contract Therapy

Posted on: November 19, 2019

A common assumption among home health providers is that outsourcing rehab services is costly.  But a close look at the benefits of contracted therapy demonstrates a very different perspective. 

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Tags: Contract Rehab, Home Health, PDGM, In-House Therapy

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

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

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