HCAF: The Villainous PDGM (SN, OT, ST, PT - 1.5 CEUs)

The Patient-Driven Groupings Model and payment methodology reform are the largest changes that home health has seen since the inception of the Prospective Payment System in 2000. While this rule has not yet been finalized, it is in the works. Under PDGM, the 60-day episode of care is replaced with a 30-day period of payment and patients are placed into one of 216 payment groups. The structure of determining the payment grouping is as follows:
(1) Musculoskeletal Rehabilitation;
(2) Neuro/Stroke Rehabilitation;
(3) Wounds - Post-Op Wound Aftercare and Skin/Non-Surgical Wound Care;
(4) Complex Nursing Interventions;
(5) Behavioral Health Care (including Substance Use Disorders); and,
(6) Medication Management, Teachingand Assessment (MMTA).

Low Utilization Payment Adjustments (LUPA) will exist in the PDGM, but there are multiple ways to calculate versus the current standard. All this and more will be addressed in this MUST HEAR session. Get the most recent, up to date data available.

Course Author: Melinda Gaboury

PT credits awarded for course completions are approved for 1 year and expire at the end of the calendar year unless otherwise stated.

For a complete list of courses offering PT credits for this year, click here.