PDGM Articles and News
What is PDGM?
The Patient-Driven Groupings Model (PDGM) is a new payment model for the home health industry that relies more heavily on clinical characteristics and patient information to determine care. It eliminates the use of therapy service thresholds and changes the basic unit of home health payment from a 60-day episode to 30 days. The National Association of Home Care & Hospice calls it “the biggest change to the payment system in the 21st century.” PDGM is set to take effect Jan. 1, 2020. To help home health business stay informed, we’ve set up this page that will keep up with the latest updates. Check back frequently for more news, guidance and learning opportunities.
BIRMINGAM, Ala. (June 2, 2020)—The coronavirus crisis has not had a huge impact on M&A activity, said Mertz-Taggart, a health care services M&A firm in their quarterly update. Rather, Q2 transactions have been predictably impacted by the Patient Driven Groupings Model.
WASHINGTON, D.C. (May 20, 2020)—The National Association for Home Care & Hospice (NAHC) is now accepting proposals to present new education at the 2020 Home Care and Hospice Conference & Expo in Tampa, Florida from October 18-20.
The deadline for submissions is Friday, May 29, 2020.
PDGM & COVID-19 strengthen the case for outsourcing
NASHVILLE, Tenn. (April 3, 2020)—PlayMaker Health, a post-acute sales enablement and business intelligence platform, announced its Q3 2019 Post-Acute Market Data Update, containing Home Health and Hospice data released in February 2020 with claims through September 30, 2019.
WASHINGTON, D.C. (February 14, 2020)—NAHC President William A. Dombi told the Senate Special Committee on Aging on Wednesday, Feb. 12th, that while the “Medicare home health benefit is well managed,” it needs to be modernized to improve access to quality care in the home for all Americans, especially those living in rural areas.
Addressing care under PDGM
DALLAS (January 13, 2020)—A new industry trends report from Axxess, a home health care technology company, and BKD, a national CPA and advisory firm, confirms concern among the home-based care industry regarding implementation of the new Patient-Driven Groupings Model (PDGM) and other regulatory changes, as well as ongoing staffing challenges.
WASHINGTON, D.C. (January 10, 2020)—The Centers for Medicare & Medicaid Services (CMS) has updated the Frequently Asked Questions (FAQs) and the Operational Guide for the Review Choice Demonstration (RCD) to include additional information on how the Patient-Driven Groupings Model (PDGM) will affect the demonstration.
Growing jobs, reducing costs & meeting needs
WASHINGTON, D.C. (November 20, 2019)—The Centers for Medicare and Medicaid Services (CMS) has issued Change Request (CR) 11527, which includes further updates to the Claims Processing Manual, chapter 10, related to the Patient Driven Groupings Model (PDGM).
Reviewing best practices & opportunities before Jan. 1
ST. PETERSBURG, Fla. (November 8, 2019)—Synzi, a virtual care company, has announced that Aspire Home Health and Hospice (Aspire), a home health and hospice provider in Salt Lake City, is using Synzi’s virtual care communication platform to better care for and engage their patient population throughout the Salt Lake, Davis and Weber counties.
DALLAS (November 8, 2019)—What will the “new normal” look like for the home health industry in and after 2020?
Washington, D.C. (November 6, 2019)—Days after the Centers for Medicare & Medicaid Services (CMS) issued its final rule governing the new payment model for home health care, industry advocates are asking for guidance from the community on what to do next.
Updated November 1 with statement from NAHC
WASHINGTON, D.C. (October 31, 2019)—The Centers for Medicare & Medicaid on Thursday, Oct. 31, issued its final rule governing the transition to the Patient-Driven Groupings Model (PDGM) for home health care—cutting its assumptions for behavioral changes almost in half.
WASHINGTON, D.C. (October 30, 2019)—To allow home health agencies to transition to the Patient-Driven Groupings Model (PDGM), which becomes effective on Jan. 1, 2020, The Centers for Medicare & Medicaid Services (CMS) is rescheduling the implementation of the Home Health Review Choice Demonstration (RCD) for the remaining states of Texas, North Carolina and Florida. The demonstration is expected to begin in Texas on March 2, 2020. The choice selection period will begin on Jan.
Preparing for revenue shortfalls before the new billing mandate