The 2018 Proposed HH Payment Rule and HHGM
Speaker(s): Melinda A. Gaboury, CEO
Category: Speaking Engagement
- This event has passed.
12:00 pm - 1:30 pm CST Hosted by
Association for Home Care & Hospice Care of North Carolina
About the Event
The 2018 Proposed Rule for Home Health will have a major impact on agencies, most significantly due to the new payment methodology introduced in this rule for 2019 Implementation: Home Health Groupings Model (HHGM) Under HHGM, the 60-day episode of care is replaced with a 30-day period of payment and patients are placed into one of 144 payment groups. The structure of determining the payment grouping is as follows: 1.Admission Source & Timing (Claims) – (Community Early, Community Late, Institutional Early or Institutional Late) 2. Clinical Grouping (Primary Diagnosis) – (Medication Management Teaching & Assessment (MMTA), Neuro Rehab, Wounds, Complex Nursing Interventions, Musculoskeletal (MS) Rehab, Behavioral Health) 3.Functional Level (OASIS Items) – Low, Medium, High 4.Comorbidity Adjustment (Secondary Diagnoses) – No or Yes Low Utilization Payment Adjustments (LUPA) will exist in the HHGM, but multiple ways to calculate versus the current standard.