Category: PDGM
PDGM Series: Functional Impairment Scoring & OASIS-D1
By Melinda A. Gaboury, CEO / Posted on: December 9, 2019Preparing 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.
VIEW POSTPDGM Series: Understanding the First Steps in Patient Grouping—Admission Source and Timing
By Melinda A. Gaboury, CEO / Posted on: November 19, 2019Transitioning 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.
VIEW POSTPDGM Series: Top 25 PDGM Questions to Ask Your Home Health Agency’s Software Vendor
By Melinda A. Gaboury, CEO / Posted on: October 21, 2019As 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.
VIEW POSTPDGM Series: Clinical Groupings & Comorbidity Adjustments
By Melinda A. Gaboury, CEO / Posted on: October 1, 2019Transitioning 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.
VIEW POSTPDGM Series: The 2020 Proposed Rule Update
By Melinda A. Gaboury, CEO / Posted on: August 27, 2019January 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.
VIEW POSTOASIS-D1 Update & PDGM Impact
By Melinda A. Gaboury, CEO / Posted on: July 1, 2019CMS 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.
VIEW POSTAre You Prepared? The Patient Driven Groupings Model (PDGM) Is Coming Soon
By Melinda A. Gaboury, CEO / Posted on: April 30, 2019Home 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.
VIEW POST2019 Home Health Proposed Payment Rule – PDGM 2020
By Melinda A. Gaboury, CEO / Posted on: August 8, 2018The 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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