How Episode Management Strategies Improved Key Performance Indicators and Increased Reimbursement for Panhandle Home Health

Overview: A Home Health Organization Committed to Care Excellence

Panhandle Home Health is a trusted provider of home health services, with decades of experience, in West Virginia’s eastern panhandle. The private, freestanding nonprofit organization delivers a variety of care services including nursing, therapy services, medical social work, dietitian support and home health aides.

The organization is celebrating its 50th anniversary, proving its resilience and ability to adapt, grow and meet industry expectations. Even with a solid operational foundation and high-quality performance, Panhandle Home Health’s leadership knew they could still improve the full episode of care.

The Challenge: Refining Episode Management to Unlock Greater Operational Value

Panhandle Home Health built a strong reputation of delivering quality care with strong clinical outcomes and patient satisfaction. But like many home health organizations operating under the patient-driven groupings model (PDGM), leadership recognized opportunities to improve key performance indicators such as periods per episode (PPE), recertification rates, functional impairment levels, outlier utilization and low-utilization payment adjustment (LUPA) performance.

Their goal was never solely financial improvement, but rather a more structured approach to help strengthen clinical decision-making, improve performance across key metrics and support better patient care.

The motivation behind this project was never solely financial. At its core, it was about delivering quality patient care. When we take good care of patients and ensure that they have a good understanding of their health status and diagnosis before discharging them – that’s providing them with the support they need and helps to make certain that they have a smooth transition to independence. To me, that is what good patient care and true quality are all about.”

– Lisa Bivens, Executive Director, Panhandle Home Health

The Solution: Supporting a Strong Foundation with Structure and Insight

Panhandle Home Health leadership turned to the McBee Episode Management Program to gain deeper insight into performance trends and strengthen oversight of clinical operations. The McBee Episode Management program is a structured approach aimed at helping organizations strengthen clinical manager oversight of field clinicians and support more consistent, patient-centered care delivery. It focuses on key performance indicators including PPE, recertification rate, LUPA rate and functional impairment level.

McBee (part of Netsmart) analyzed Panhandle Home Health’s organizational data, identified opportunities for improvement, and worked closely with leadership and clinicians to implement targeted strategies focused on key performance indicators. Through education, coaching, ongoing reporting and collaborative performance reviews, the team established a framework for consistent performance improvement.

As changes were implemented, leadership was able to monitor progress through regular performance reporting and coaching sessions.

In home health, meaningful change can take time to show up in the data. One of the most valuable aspects of the McBee engagement has been the monthly reporting, which gives us consistent visibility into our progress. We’re able to see the value of the work we’re doing and the improvements we’re making along the way.”

– Lisa Bivens, Executive Director, Panhandle Home Health

The Results: Where Clinical Excellence Helps Drive Financial Performance

By creating greater visibility into performance and strengthening accountability across the organization, Panhandle Home Health increased reimbursement by optimizing PPE, supporting clinically appropriate recertifications and minimizing avoidable LUPA. They achieved measurable improvements including:

• Increased their PPE from 1.46 to as high as 1.72¹
• Increased Recert rate from 15.33% to as high as 36.92%²
• Decreased their LUPA rate from 8.53% to as low as 2.36%³

More importantly, the improvements reflected a stronger and more consistent approach to patient management. Patients received care that was better aligned with their needs, resulting in improved engagement and a smoother transition throughout their care journey.

As a result of leveraging Episode Management Services, Panhandle Home Health increased reimbursement by increasing their PPE from 1.46 to as high as 1.72¹, increasing their Recert rate from 15.33% to as high as 36.92%², and decreasing their LUPA rate from 8.53% to as low as 2.36%³.

Building a Culture of Continuous Improvement in Home Health

Panhandle Home Health had already established a strong foundation of quality care but recognized opportunities to improve key performance indicators and operational consistency. By leveraging the McBee Episode Management program, the organization gained the structure, insight and accountability needed to drive meaningful change while building on its existing strengths.

Panhandle Home Health's journey is an example of how the right strategy and support can help high-performing organizations achieve greater results. Combining clinical excellence with disciplined Episode Management practices helped Panhandle Home Health improve key performance indicators, increase reimbursement, and strengthen its ability to deliver the right care, at the right time, for every patient.

This work has helped create a stronger culture of teamwork, with everyone aligned around shared goals. Our team understands what we’re trying to accomplish and has truly bought into the process. That kind of alignment is what will help sustain these improvements moving forward.”

– Lisa Bivens, Executive Director, Panhandle Home Health

¹ Comparing the baseline PPE (average PPE during 9/1/23 through 8/31/24) to the PPE from November 2025 ² Comparing the baseline Recert rate (average Recert rate during 9/1/23 through 8/31/24) to the Recert rate from January 2026 ³ Comparing the baseline LUPA rate (average LUPA rate during 9/1/23 through 8/31/24) to the LUPA rate from December 2025