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How Home Health Agencies Can Prepare for PDGM

Posted on Sunday, February 3, 2019 5:36 PM

Once it becomes effective in 2020, Patient Driven Groupings Model (PDGM) will revolutionize how home health operates and will double billing efforts.

NAHC President Bill Dombi is urging home health agencies to not overreact to PDGM by severely cutting therapies offered to patients. 

“Over the years, concerns have been raised by Congress, by CMS, by the Office of Inspector General (OIG) and the Government Accountability Office (GAO) that the existing model incentives high volumes of therapy services because reimbursements were increased accordingly,” he said. “But we see great value to the therapy services that have been provided under the Medicare home health benefit.”

While the model was created to address problems that exist under the home health care Prospective Payment System (PPS), many industry leaders worry some aspects of PDGM — such as case-mix changes and widely opposed behavioral adjustments — will hurt agencies. “

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