This webinar will take home health agencies through an introduction of the Patient-Driven Groupings Model (PDGM) structure from the creation of a Home Health Resource Group (HHRG) and the corresponding case-mix weight to how the determination of a Low Utilization situation is reviewed. There will also be a review of the financial estimates CMS has made and the effect PDGM will have on cash flow.
Outline the Health Insurance Prospective Payment System (HIPS) code make up.
Define case mix categories under PDGM.
Discuss admission source and timing.
Outline findings from the CMS data base.
Review current PDGM data.
Home health CEO, CNO, Managerial staff, supervisors, clinical staff, quality improvement staff and any other interested parties.
Melinda A. Gaboury is co-founder and CEO of Healthcare Provider Solutions, a provider of financial, reimbursement, billing, operational and clinical consulting to the home care and hospice industries. She has more than 27 years in home care and more than 17 years of executive speaking and educating experience with home care and hospice professionals. Gaboury has experience in Medicare prospective payment system training, billing, collections, case-mix calculations, chart reviews, due diligence and Medicare Administrative Contractor appeals. She is currently serving on the National Association for Home Care & Hospice/Hospice Financial Mangers Association advisory board as ex-officio and is associate director on the Home Care Association of Florida Board of Directors. Ganpiru is also the author of the “Home Health Pocket Guide to OASIS-C2: A Reference Guide for Field Staff”.