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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Home Health,
PDGM,
Patient-Driven Grouping Model,
CMS Update 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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Home Health,
PDGM,
Home Health Agency
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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Home Health,
PDGM,
Patient-Driven Grouping Model,
CMS Update 2020
Review Choice Demonstration came to Ohio September 30th, 2019 and hot on its heels is PDGM. The more prepared you are for all of the changes that come, the better poised your agency will be in the coming months and years.
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Home Health,
PDGM,
Home Health Agency
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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Home Health,
PDGM,
Patient-Driven Grouping Model
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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Home Health,
PDGM,
Patient-Driven Grouping Model,
Home Health Agency,
CMS Update 2020
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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Home Health,
PDGM
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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Contract Rehab,
Home Health,
PDGM,
In-House Therapy
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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Home Health,
PDGM,
CMS Update 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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Home Health,
PDGM,
OASIS Assessment