HCAF 2020 Home Care Warm Up

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Thriving in 2020: How to Use PDGM as a Starting Point to Value-Era Success

Tuesday, January 14

12:45-3:15 PM

Presented by Arnie Cisneros, Home Health Strategic Management (HHSM)

IMPACT Act reforms have come to the home health industry and they outline a new care path for the pending value era. The Patient-Driven Groupings Model (PDGM) installed for 2020 home health programming, is just the first of the reforms we will confront in the next few years. Medicare changes to the acute episode are affecting providers across the care continuum, from hospitals to home health agencies, and the PDGM is focused on preparing home health to address post-discharge patient needs. By examining the response of Medicare providers outside of home health, we can identify care development and delivery goals that fit the PDGM and subsequent reforms. Through this approach, we can identify where traditional home health care programs may fail to achieve the goals of the value reforms.


But, success under the PDGM will require significant changes from how we have operated under the Prospective Payment System (PPS); these changes will challenge many home health industry beliefs we have operated within for years. Philosophical changes may be required, but the PDGM era is designed to morph traditional home health programs into a more value-based model. In addition, many of the PDGM-designed changes to the home health model are required for success under subsequent IMPACT Act reforms, such as pre-claim review and post-acute PPS.


This progressive presentation will address how to achieve the PDGM success today as you prepare for future value-based IMPACT Act reforms.