EVENTS
How Medicare Reimbursement Is Impacted by OASIS & Outcome Programs (MHCA)
Speaker(s): Melinda A. Gaboury, CEO
Category: Home Care
Speaker(s): Melinda A. Gaboury, CEO
About the Speaker(s)
Melinda A. Gaboury, with more than 30 years in home care, has over 22 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving as the Chair of the NAHC/HHFMA Advisory Board and Work Group and is currently serving on the Board of Directors for both the Home Care Association of Florida & Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.
Jan 2210:00 am - 11:30 am CST Hosted by
MHCA
Add to Google CalendarAdd to iCal Calendar
Keep up with all the latest from HPS!
Click Here to subscribe to our newsletter.
About the Event
January 22, 2026
10:00am – 11:30am CST
How Medicare Reimbursement Is Impacted by OASIS & Outcome Programs
Numerous factors contribute to the calculation of Medicare reimbursement under the Patient Driven Groupings Model (PDGM), as well as various other programs that can also impact reimbursement. Home Health Value-Based Purchasing (HHVBP), Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS), and the Home Health Quality Reporting Program (HHQRP) program can all have a reimbursement impact for Medicare claims. This session will review the details of these programs and how they directly impact reimbursement for home health agencies.
Objectives:
- Identify all elements that are used to calculate the PDGM HIPPS codes for payment
- Detail the elements that are used in the HHVBP Total Performance Score (TPS) and how the Linear Exchange Function (LEF) is used to calculate the impact on future Medicare payments.
- Review the measures in the HHCAHPS model that impact the HHCAHPS Star Ratings and impact the calculation of HHVBP and therefore impact payment
- Outline the requirements of the HHQRP and how noncompliance will create a 2% decrease in future payments.