The Patient Driven Groupings Model (PDGM) continues to live up to the hype surrounding its launch on January 1 of this year. Since its inception, PDGM has proven to be a handful for providers trying to work out best practices under the new model. Known as the most sweeping change in home health reimbursement in 20 years, PDGM has required home health agencies to change every corner of their operations, from intake to care management to coding and billing.
eSolutions has been there every step of the way, helping agencies make sense of PDGM so their cash flow and financial health remain strong. As the Medicare experts, we have helped hundreds of home health agencies implement the right revenue cycle management processes to maximize reimbursement and performance under PDGM.
Melinda Gaboury, COS-C, CEO and founder of Healthcare Provider Solutions, Inc., joined us for an exclusive Q&A session focused not only on the impact of COVID-19, but also on how the crisis amplifies other major industry shifts, like PDGM, Review Choice Demonstration, and more.
Simply put, PDGM has proven to be a handful for most home health organizations. Agencies across the nation are trying to determine best practices for success under the new payment model. Check out the Top 5 Ways your HHA is Leaving Money on the Table.
Effective March 30, certain claims processing requirements for the Review Choice Demonstration (RCD) were paused in Illinois, Ohio, and Texas, until the public health emergency for the COVID-19 pandemic has ended. Home health agencies can source information and resources here.
While RCD may be paused during the COVID-19 crisis, it’s otherwise here to stay and eventually coming for providers in North Carolina and Florida. If the demonstration hasn’t yet hit your state, it’s never to early to get ready! Prepare your agency for RCD with our informative eBook that’s packed full of everything you need to know to succeed.
If your agency is still feeling a little frazzled or confused by PDGM and the changes it brought this year, don’t hit the panic button. We’ve got tips on how HHAs can focus less on administrative duties under PDGM and more on delivering care – read more here.
To find out more about PDGM, the Centers for Medicare & Medicaid Services (CMS) offers a wealth of resources online: