2018 Final Rule for Home Health


The 2018 Final Rule for Home Health will have a major impact on agencies, most significantly due to the new payment methodology introduced in this rule for 2019 Implementation, assuming it is finalized. In addition to the HHGM Home Health Groupings Model (HHGM), this final rule brings rate changes for 2018 Home Health PPS, changes to the Value Based Purchasing Pilot, and numerous considerations for HHQRP changes.

Under HHGM, the 60-day episode of care is replaced with a 30-day period of payment and patients are placed into one of 144 payment groups. The structure of determining the payment grouping is as follows:

          1. Admission Source & Timing (Claims) - (Community Early,               Community Late, Institutional Early or Institutional Late)
          2. Clinical Grouping (Primary Diagnosis) - (Medication Management
              Teaching & Assessment (MMTA), Neuro Rehab, Wounds, Complex               Nursing Interventions, Musculoskeletal (MS) Rehab, Behavioral               Health)
          3. Functional Level (OASIS Items) - Low, Medium, High
          4. Comorbidity Adjustment (Secondary Diagnoses) - No or Yes

Low Utilization Payment Adjustments (LUPA) will exist in the HHGM, but multiple ways to calculate versus the current standard. All this and more will be addressed in this must hear webinar.

  • Detail new PPS rates & changes to case mix weights for 2018
  • List core changes to the PPS system as a result of the HHGM
    proposed for 2019
  • Document changes to the Home Health Quality Reporting
    Program (HHQRP)



Melinda Gaboury, COS-C

Healthcare Provider Solutions, Inc.

Founder & CEO of Healthcare Provider Solutions, Inc. Melinda Gaboury and Mark Cannon founded the company in April 2001 to provide financial, reimbursement, clinical and cost reporting services to home health agencies and hospice.

Prior to the inception of Medicare PPS Gaboury began researching, auditing and review processes with OASIS, ICD-9 Coding and clinical documentation. She has developed and taught clinician and billing Medicare PPS Training Workshops in a variety of venues.

Gaboury’s priority remains bridging the gap between clinical and financial issues in home health agencies. Gaboury has been a speaker for several state home care associations. In addition to her speaking engagements and consulting, she is author of Home Health Pocket Guide to OASIS-C.


Provider approved by the California Board of Registered Nursing (Provider #CEP2463) for one (1) contact hour of continuing education. You must be present for the entire webinar to earn Continuing Education Units.

At the completion of the webinar, you will be directed to complete an online evaluation form, which is required in order to obtain a certificate of completion. Please allow 1-2 weeks for your certificate to arrive via mail.


No cancellations or refunds will be issued once user login information has been sent. Unfortunately, due to the online format of this program we are unable to offer exceptions to this policy. It is recommended that each registrant review the course content prior to submitting payment to ensure the content meets individual educational needs.