The Patient-Driven Groupings Model (PDGM) went into effect on January 1, 2020. This is the most significant change to the Medicare home health reimbursement structure since the introduction of the Prospective Payment System (PPS) in 2000. The new payment model has dramatically impacted agency operations, processes, and performance.
January 2023 brings even more issues with rate changes for home health and the impending Home Health Value-Based Purchasing (HHVBP) nationwide expansion. This four-part webinar series will discuss key areas, strategies, and processes in assisting an agency in staying ahead of PDGM-related changes and reimbursement rates. This program will focus on best episode management and process improvement practices including the referral, intake, and scheduling processes, timely documentation, and physician and patient communication strategies — all of which are required to more tightly manage care within the 30-day payment period.
At the conclusion of this program, the participant will be able to:
- Understand the Payment Patterns Electronic Report (PEPPER) and how it relates to 30-day final claims
- Explain the specific targets and data behind the calculation
- Understand the PEPPER scores and comparisons to national statistics
- Understand the PEPPER data effect on medical review
- Explain the process for providers to evaluate data and implement a plan of correction if needed
By completing/passing this course, you will attain the certificate HCAF Course Certificate
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