Tag: case-mix

What to consider: SNF Proposed Rule for 2020

The following was written by Reg Hislop for Reg’s Blog. Reposted with permission. . The SNF proposed rule is best characterized as mostly good news. The best news is the proposed market-basket (rate inflation) update of 3%. Subtracting the productivity factor of .5% from the update, SNFs will see a rate increase of 2.5% starting […]

Educate clinicians about M1820, an item affecting functional points under PDGM

Source: Home Health Line Ensure clinicians have proper training about how to respond to the OASIS-D item involving patients’ ability to dress their lower body safely. M1820 (Ability to dress lower body) is one of six OASIS items that affect functional case-mix adjustment under the PPS, and it will be one of eight items that […]

HIPPS groups with the lowest and highest case-mix weights under PDGM

The following 15 HIPPS groups will have the lowest and highest case-mix weights under PDGM, according to the 2019 PPS final rule. The following 15 HIPPS groups will have the lowest case-mix weights under PDGM, according to the 2019 PPS final rule. HIPPS Clinical group and functional level Timing and admission source Comorbidity adjustment Weight 3GA11 […]

CMS releases FY 2019 proposed rule, includes RCS-1 replacement

CMS has posted a proposed rule for FY 2019. The proposal not only changes payment rates, but also proposes a new case mix grouping called the Patient-Driven Payment Model, or PDPM. This model replaces the RCS-1 that was proposed in May of last year. According to CMS, this new system has 80% fewer groupings and […]

CMS releases finalized home health PPS rule

The Center for Medicare & Medicaid Services (CMS) has released the finalized prospective payment system rule for 2017. The final rule cuts Medicare reimbursement to home health agencies slightly less than the proposed rule did earlier this year—now by $130 million as opposed to $180 million. The final rule implements the fourth and final year […]