EVENTS
Mastering PDGM: Financial, Quality & Strategic Management
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.
Feb 25 - Feb 26, 20269:00 am - 4:00 pm Hosted by
Healthcare Provider Solutions
About the Event
This comprehensive day of The Patient Driven Groupings Model (PDGM) is going to give agencies the biggest and best chance to fully understand the current model and coming changes. This will assist in confirming the need for additional changes within your agencies. This workshop provides a quick overview of the PDGM structure and operations along with a review of the concerns and opportunities triggered by PDGM. The Financial portion of the workshop will assist agencies in monitoring their impact and analyzing what will be necessary to adjust with coming updates in 2026. Strategic Management will include operational decisions regarding the Revenue Cycle, Clinical Operations and Quality reporting. The Home Health Value-Based Purchasing Model which has taken our agencies by storm will be detail reviewed in analyzing the first two years of results and where we are headed with 2026 changes.
9:00 – 10:30 Session 1 – PDGM Structure
- Outline the structure of PDGM
- Review the pieces of the HIPPS Code
- Review the reimbursement changes specific to coding
- Review the impact of billing errors
10:30 – 10:45 Break
10:45 – 12:00 Session 2 – Home Health Quality Reporting Program
- Detail criteria for HHQRP
- Review the requirements of the OASIS/HHCAHPS Participation Compliance
- Review Details of the 2026 NEW HHCAHPS Survey effective April 1, 2026
- Review NEW HHQRP Star Ratings – the result of survey & OASIS changes.
12:00 – 1:00 LUNCH
1:00 – 2:30 Session 3 – Home Health Medical Review
- Detail Specific Medicare Medical Review Issues affecting Home Health
- Review 2026 HH Face-to-Face Requirements
- Detail key billing codes that trigger Medical Review
- Audit Risks – CMS Targeted Probe & Educate, SMRC, UPIC & RAC
- Top 5 Denials and Avoiding those denials
2:30 – 2:45 Break
2:45 – 4:00 Session 4 – Home Health Value Based Purchasing Model
- Detail the HHVBP Model & Most Recent Results
- Review details of the measures in the HHVBP Model for 2026
- Detail review the Interim Reports
- Review Best Practices for Improving Scores