Welcome to the HealthPRO Heritage Blog

HHS Announcement: More Provider Relief Funding Available

Posted on: October 9, 2020

HHS announced $20 billion in new funding for providers on the frontlines of the COVID-19 pandemic. This Phase 3 distribution was made possible through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act (which allocated $175 billion in relief funds to hospitals, skilled nursing, home health and other healthcare providers.) Skilled nursing & home health providers and others who have received Provider Relief Fund payments (and some who were previously ineligible providers) are invited to apply for additional funding to cover operating expenses caused by the COVID-19 pandemic.

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Tags: snf, senior living, LTC, Home Health, CMS Update 2020, COVID-19

In a Year of Tricks, CMS Drops a TREAT with Home Health Final Rule

Posted on: September 24, 2020

CMS released the 2021 home health final rule on Thursday, October 29, 2020. HealthPRO Heritage at Home sorted through the mixed bag and found more treats than tricks!

There were minimal changes compared to the home health proposed rule that was released in July 2020. Probably the best news in the rule was the 1.9% aggregate increase (or $390 million) in reimbursement that agencies will realize in 2021. Although the increase was less than the original 2.6% increase that was in the proposed rule.

Other highlights from the final rule are as follows:

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Tags: Home Health, PDGM, Home Health Agency

Twelve New PDGM Home Health Clinical Pathways

Posted on: September 8, 2020

Earlier this year in quarter one, the National Association of Home Care and Hospice (NAHC) released preliminary data specific to the early PDGM claims and trends*. This was our first opportunity to be able to begin benchmarking performance compared to the trends that were occurring across the home health industry. HealthPRO Heritage at Home then performed a deeper investigation into each specific PDGM clinical grouping and determined...

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Tags: Home Health, PDGM

Home Health Proposed Rule for CY2021

Posted on: July 3, 2020

On June 26, 2020, the Centers for Medicare and Medicaid Services (CMS) released the Home Health proposed rule for 2021.

There were little to no changes with the PDGM payment model and it’s clear that PDGM is here to stay.  Additional highlights from this proposed rule are listed below:

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Tags: Home Health, PDGM

Home Health Pledge & Plan Amid COVID

Posted on: June 25, 2020

As the number of new COVID-19 cases rise and fall across the country, HealthPRO Heritage at Home reminds you that we are prepared above & beyond. Our 3-prong approach + Partnership Pledge provides support in the case of a second wave, or if infections increase in your market.

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Tags: Home Health, PDGM, COVID-19

Home Health Clinical Excellence

Posted on: June 10, 2020

For 15+ years, HealthPRO Heritage at Home has served the therapy needs of home health agencies who have counted on us as a trusted partner to address the challenges and opportunities unique to home health.

As the industry navigates changes brought by PDGM and COVID-19, HealthPRO Heritage at Home is well prepared to support partners with meaningful guidance and sophisticated resources that fortify operational success, financial growth, and clinical excellence, including:

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Tags: Home Health, PDGM, COVID-19

The Dangers of Therapy Underutilization Part 2: The Effect of Patient Outcomes on Star Ratings

Posted on: March 6, 2020

The Patient Driven Grouping Model (PDGM) was implemented January 1, 2020 and changed reimbursement models of Medicare home health services from therapy utilization driven to patient characteristics. While this has allowed for a focus from quantity to quality, some home health agencies are restricting therapy visits and placing their quality measures, Star Rating, and most importantly patient outcomes at risk. CMS calculates Star Ratings through several areas therapy may influence including, ambulation, bed transfers, bathing, discharge location, and rehospitalizations.

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Tags: Home Health, Senior Living Community, PDGM, Patient-Driven Grouping Model, Home Health Agency

CMS Watching Home Health Providers Closely Amid Shifting Therapy Strategies

Posted on: February 28, 2020

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

The Dangers of Therapy Underutilization - Part 1: The CMS Perspective

Posted on: February 18, 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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Tags: Home Health, PDGM, Home Health Agency

Measuring PDGM Success - Industry Expert Weighs In

Posted on: February 5, 2020

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