Tag: PDGM

CMS to hold home health, hospice open door forum

CMS will hold its next home health, hospice and durable medical equipment open door forum at 2 p.m. EST on Nov. 6. Topics will include the home health payment rule and the review choice demonstration as well as a home health billing update related to the Patient-Driven Groupings Model (PDGM). View the agenda at https://go.cms.gov/1TlLRb4.

CMS’ October release of quarterly OASIS Q&As offer guidance on PDGM, OASIS-D1

The latest release of CMS OASIS quarterly Q&As delve into issues around the Patient-Driven Groupings Model (PDGM) and OASIS-D1 as well as GG items capturing mobility and self-care. The October 2019 Q&As — published to the CMS website Oct. 15 — include 37 questions and responses on a range of topics. PDGM was the dominant […]

Post-Acute Wound Management and Patient-Derived Reimbursement Models

By: Roger B. Schechter, MD, Fellow of American College of Wound Specialists; Chief Medical Officer, Synergy Wound Technology Wound care has always been a considerable challenge in the post-acute setting. Patients with skin breakdown usually have a plethora of chronic comorbid conditions. Chronic wounds themselves, including pressure injuries, diabetic foot ulcers, venous leg ulcers, severe […]

Home Health and SNF CMS call recording now available

Home Health Call: Audio Recording and Transcript An audio recording, transcript, revised presentation, and clarification are available for the August 21 Medicare Learning Network call on the Home Health Patient-Driven Groupings Model (PDGM): Operational Issues. Learn information to help your agency prepare to implement billing changes for the PDGM on January 1, 2020. SNF Value-Based […]

CMS puts more weight on behavioral assumptions, but increases payments by 1.3%

CMS is seeking to reduce agency payments even more than expected to account for assumed behavioral changes agencies will make as part of the Jan. 1, 2020, implementation of the Patient-Driven Groupings Model (PDGM). Even with the shift from 6.42% to an 8.01% reduction in agencies’ payments due to behavioral changes, the home health industry […]

Proposed rule: CMS moving forward with PDGM in 2020

CMS is staying true to plans to implement a new payment model. The 2020 PPS proposed rule, which was posted to the Federal Register July 11, reinforces the plan to implement the Patient-Driven Groupings Model (PDGM) beginning on or after Jan. 1, 2020. The model will move from 60-day episodes to 30-day payment periods. While […]

Proposed bill would innovate use of home health services

The Home Health Payment Innovation Act of 2019, H.R. 2573, would preserve Medicare recipients’ access to home health services and provide a pathway for innovative approaches to using these services. According to LeadingAge, which supports the bill, H.R. 2573 would prevent unwarranted payment rate cuts of Patient Driven Groupings Model (PDGM) by basing any behavioral […]