Friday, November 08 | Legislative/Policy, Post-Acute Care, EHR Solutions and Operations, Partnerships and Collaboration

CMS Finalizes Home Health Payment Rule

By Netsmart

The Centers for Medicare & Medicaid Services (CMS) finalized the much anticipated Home Health Final Rule October 31.  This rule finalized changes for the Patient-Driven Groupings Model (PDGM) that will go into effect on January 1, 2020.
 
The good news is that, overall, CMS’s final rule for 2020 increases Medicare payments by an estimated 1.3% — or about $250 million. 
 
But perhaps the biggest news for U.S. home health providers is a major update to PDGM’s widely opposed and controversial behavioral adjustment.  In the Final Rule, CMS lowered the behavioral adjustment from 8.01% to 4.36%, which is “a big win for home health” says Mike Dordick, McBee President.  
 
 
Netsmart and McBee will continue to advocate for the home health industry. Our goal is to prepare our clients for PDGM and help our industry succeed. 
 
You should start preparing for PDGM now. Ensure you have strong co-morbidity and diagnosis coding in place. 
 
To learn about what you need to succeed under PDGM, visit our PDGM resource page here. 
 

 

Meet the Author

netsmart-logo
Netsmart ·

From the CareThreads Blog

The Hidden Gaps Driving Audit Risk in Post-Acute Care

The Hidden Gaps Driving Audit Risk in Post-Acute Care

Wednesday, October 07 | Post-Acute Care,Thought Leadership

Organizations can no longer afford to approach audit readiness as the responsibility of one department. It requires a connected strategy that spans the entire revenue cycle and helps identify risk before it becomes an audit finding.

Read the blog
The Metrics Driving Sustainable Senior Living Growth

The Metrics Driving Sustainable Senior Living Growth

Why growing census does not always produce healthier margins, and what leaders should measure instead

Tuesday, October 06 | Care Coordination,Post-Acute Care,Thought Leadership

Over the years, occupancy became a go-to statistic for senior living. It showed if your building was full, you were generally making more money, but the economics of senior living have changed.

Read the blog
Why Reducing Variability Matters in Wound Care

Why Reducing Variability Matters in Wound Care

Tuesday, September 08 | Post-Acute Care,Care Coordination,Thought Leadership

When it comes to wound care, the challenge for many post-acute organizations isn't a lack of clinical experience. It's making sure everyone has the same understanding of the wound and that the information needed to make decisions is complete, consistent and accessible.

Read the blog