Category: PDGM

COVID-19: Imperative Home Health and Hospice Updates

By Melinda A. Gaboury, CEO / Posted on: April 1, 2020

As we are facing the pandemic of the century, home health and hospices are on the frontline of this Public Health Emergency (PHE) along with hospitals, physicians and all other healthcare workers. We at Healthcare Provider Solutions, Inc. would like to take this moment to thank each and every one of you for your true dedication to treating patients and helping the world to be a healthier place. HPS is dedicated to providing the Home Health and Hospice industries with the education and resources necessary to keep you performing at the highest level of success.

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PDGM Series: Top Five Ways to Avoid Losses!

By Melinda A. Gaboury, CEO / Posted on: February 11, 2020

Agencies across the nation are trying to figure out the best practices for being successful under PDGM. Explore the Top 5 things agencies should focus on to avoid significant losses under PDGM.

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PDGM Series: Functional Impairment Scoring & OASIS-D1

By Melinda A. Gaboury, CEO / Posted on: December 9, 2019

Preparing for PDGM: Step 3 in establishing a Home Health Resource Group (HHRG) and case-mix weight is patient Functional Impairment based on OASIS-D1 responses.

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PDGM Series: Understanding the First Steps in Patient Grouping—Admission Source and Timing

By Melinda A. Gaboury, CEO / Posted on: November 19, 2019

Transitioning to the Patient-Driven Groupings Model (PDGM) has already begun to impact operations for home health agencies that are indeed convinced that preparation should be underway. The first two pieces to the puzzle in establishing a Home Health Resource Group (HHRG) and corresponding case-mix weight are Admission Source and Timing. Both of these items are extremely important and will need meticulous attention at the Start of Care (SOC) and, for the Admission Source, that attention will need to continue into subsequent 30-day payment periods.

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PDGM Series: Top 25 PDGM Questions to Ask Your Home Health Agency’s Software Vendor

By Melinda A. Gaboury, CEO / Posted on: October 21, 2019

As home health agencies continue to plan for the implementation of PDGM there are some very important questions that agencies should be asking of the software vendors/electronic medical records (EMR) that will be utilized for clinical documentation and billing of Medicare Home Health claims.

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PDGM Series: Clinical Groupings & Comorbidity Adjustments

By Melinda A. Gaboury, CEO / Posted on: October 1, 2019

Transitioning to the Patient-Driven Groupings Model (PDGM) has already begun to impact operations for home health agencies that are indeed convinced that preparation must begin now.  Diagnosis coding and OASIS ADL data are two significant areas that the agency can impact by deeper education and understanding of both items.  Clinicians must understand the dire importance of including the appropriate disease processes in the assessment of the patient and development of care plans.

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PDGM Series: The 2020 Proposed Rule Update

By Melinda A. Gaboury, CEO / Posted on: August 27, 2019

January 1, 2020 will bring many new beginnings, including the Patient Driven Groupings Model (PDGM). No doubt the largest reimbursement system overhaul in home health since October 2000.
CMS continues to tweak the model and updates to the Claims Processing Manuals have begun.

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OASIS-D1 Update & PDGM Impact

By Melinda A. Gaboury, CEO / Posted on: July 1, 2019

CMS has announced that the revised OASIS-D1 instruments will be effective January 1, 2020. Changes to the OASIS-D data set and data collection guidance were finalized in the Calendar Year (CY) 2019 HH Final Rule, CMS 1689-FC.

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Are You Prepared? The Patient Driven Groupings Model (PDGM) Is Coming Soon

By Melinda A. Gaboury, CEO / Posted on: April 30, 2019

Home health agencies may find many of the changes to OASIS-D daunting, but there are several modifications that have helped make assessments easier than ever before. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) is the primary driving force behind the OASIS changes.

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2019 Home Health Proposed Payment Rule – PDGM 2020

By Melinda A. Gaboury, CEO / Posted on: August 8, 2018

The Centers for Medicare and Medicaid Service (CMS) released the CY2019 Medicare Home Health payment rule July 12, 2018. This proposed rule is voluminous and carries an immense number of proposed changes. HPS will continue analyzing and updating the proposed elements of this rule.

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