Despite Challenges, Some See Upside in PDGM’s Therapy Overhaul
Posted on Monday, November 4, 2019 12:39 PM
The Patient-Driven Groupings Model (PDGM) is starting shortly, and its impact on therapy utilization is sending shockwaves throughout the home health industry.
Many companies have laid off therapists ahead of the change, looking toward more nursing services especially for wound care. This has already happened in the skilled nursing arena, which switched to the Patient-Driven Payment Model (PDPM) on Oct. 1.
“I think all providers had a strategy going into PDPM that they are implementing as we speak,” Aegis Therapies CEO Martha Schram told Home Health Care News. “We’ll all have to gather more information over the next weeks and months to be sure, and I’m sure as an industry we will all find some adjustments we need to make.”
PDGM is designed to correct what CMS officials see as an overuse of therapy under the current Prospective Payment System (PPS) for home health care. To make that correction, PDGM ties therapy reimbursement to patient characteristics rather than the sheer volume of services delivered.
For therapy-heavy home health providers, the change from PPS to PDGM is going to be epic.
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