Patient-Driven Groupings Model Workshop



PROGRAM OVERVIEW

The Patient-Driven Groupings Model (PDGM) represents the most significant change to the Medicare Home Health program in the 21st Century. It will radically change the payment methodology, including the unit of payment, the case mix adjuster, Low Utilization Payment Adjustment standards, and payment for Non-Routine Medical Supplies.

By attending this workshop, you will be fully prepared to successfully navigate these radical changes coming to Home Health care. You cannot afford to miss it!

Program Topics:
With program sessions, within this one-day workshop, covering a variety of topics including a PDGM Overview, Clinical, Financial, Operations, Business Analytics, and Technology, you will:
  • Gain a better understanding of what PDGM means for you and your agency
  • Identify key threats to the Home Health industry and how to overcome them
  • Strategically develop a process to lessen the impact of PDGM on your Home Health agency
  • Discuss the steps NAHC has taken, is taking and will take in the future to address areas of concern.
Additional Workshop Details:
The National Association for Home Care & Hospice (NAHC), in partnership with the NAHC Forum of State Associations, the Home Care and Hospice Financial Manager Association, and the Home Care Technology Association of America is embarking upon a series of 12 one-day workshops across the country specifically focused on the upcoming changes to PDGM. For information on sponsoring all 12 workshops, please contact Christopher Adams at cta@nahc.org.

SESSIONS

Overview
The Patient Driven Groupings Model (PDGM) is the biggest change that has faced home health agencies in nearly two decades. This program provides a quick overview of the PDGM structure and operation along with a review of the concerns and opportunities triggered by PDGM. It helps form the base of understanding of PDGM needed for the conference in chief.

Topics:
  • Identify the structural framework of PDGM in comparison to the current payment model, HH PPS.
  • Explain the rationale behind the PDGM changes
  • Identify the concerns and opportunities in PDGM along with ongoing PDGM reform efforts.
Clinical
With the implementation of PDGM there are many challenges that agencies will face from a clinical vantage point. Documentation, care planning and care coordination are at the top of the list of best practice clinical strategies that will need to be reviewed. This session focuses on the interdisciplinary care planning, case conferencing and case management that are going to be imperative in effectively transitioning to the PDGM model. 

Topics:
  • Outline the OASIS ADL Section & ICD-10 Coding Impact on the Home Health Resource Group (HHRG) under PDGM.
  • Describe how interdisciplinary care planning can manage cost effective and appropriate skill mix, including therapy utilization under the PDGM.
  • Outline best practice clinical strategies for managing LUPA thresholds as defined by PDGM.
  • Define the Clinical Manager role in the Clinical Team’s success under PDGM, including the significance of effective case conferencing and case management.
Financial
Thriving (or even surviving) under the PDGM payment reform requires a clear understanding of how PDGM will affect financial outcomes in a home health agency. This session explores the fundamental steps necessary for home health agencies to assess the impact of PDGM on their operations and determine specific implications for budget and cash flow.

Topics:
  • Measure the financial impact on your organization
  • Recognize how PDGM will affect Revenue Cycle department and what you should do to adapt
  • Identify the role that your finance team will play as an integral part in preparing for PDGM

Operations
The new PDGM payment model will require agencies to consider process changes in their business operations. Operational areas likely impacted under the new payment model include referral and sales management, intake, revenue cycle, operational reporting, order and supply management, etc. This session will outline the areas impacted and provide recommendations for potential process changes to optimize operations performance under PDGM.

Topics:
  • Outline how PDGM will require agencies to consider process changes in their business operations
  • Define key areas of operations that will likely require process changes and the operational risks involved if process changes are not made
  • Identify recommendations and strategies for process revisions and adjustments to achieve a successful operational transition into PDGM

Business Analytics
Changing from the HH PPS reimbursement system after 20 years to PDGM is complicated.  CMS has provided some data on the revenue impacts and new PDGM components, but there is much more to be considered.  This program is a deeper dive into some key data analytics to better inform you of the overall impacts and useful benchmark data you can use at your agencies.

Topics:
  • Achieve meaningful insights on clinical categories, utilization and other characteristics using claims data
  • Provide data drill downs on LUPA, lengths of stay and other operational metrics under PDGM
  • Obtain the tools and Key Performance Indicators to help prepare and run your organizations

Technology
Your technology business partners are crucial participants in your preparation and ability to support PDGM. In this segment, technology leaders from NAHC’s Homecare Technology Association of America (HCTAA) will share recommendations on how best to engage your business partner for a successful PDGM adoption. 

Topics:
  • Evaluate your business partner’s readiness
  • Leverage business partner informational and design sessions
  • Identify internal budget and skills in preparation of major system upgrades

PDGM Overall Change Management Open Panel
This part of the program brings together all the covered topics in an open forum for discussion with attendees. The faculty team will explore the integration and overlap of matters related to Operations, Clinical Services, Financial Management, Business Analytics, and Technology. It is intended as an interactive faculty/attendee open forum.

Session Schedule:
7:00 am – 8:00 am: Breakfast/Registration
8:00 am – 8:30 am: PDGM Overview
8:30 am – 9:45 am: Clinical
9:45 am – 10:00 am: Break
10:00 am – 11:00 am: Financial
11:00 am – 12:15 pm: Operations
12:15 pm – 1:00 pm: Lunch (provided)
1:00 pm – 2:15 pm: Business Analytics
2:15 pm – 2:30 pm: Break
2:30 pm – 3:15 pm: Technology
3:15 pm – 4:00 pm: Joint Panel

 

FACULTY


Clinical Speakers:
Kim Skehan, Simione Healthcare Consultants and Cindy Campbell, Fazzi Associates
Financial Speakers:
Mike Dordick, McBee and Mike Simione, Simione Healthcare Consultants
Operations Speakers:
Keith Boroch, McBee and Gina Mazza, Fazzi Associates
Business Analytics Speaker:
Christine Lang, ABILITY
Technology Speaker:
TBD



CANCELLATIONS

Cancellations are subject to 20% handling fee. There will be NO REFUNDS issued for cancellations received within 10 business days prior to program. Cancellations must be in writing. Refunds will not be made for no-shows. However, substitutions will be allowed. Should CAHSAH® cancel the program, a full registration fee refund will be issued.



CERTIFICATE OF COMPLETION
& CONTINUING EDUCATION UNITS (CEUs)

Six and one half (6.5) contact hours of continuing education provided by NAHC. You must be present for the entire workshop to earn Continuing Education Units. No partial credits can be given.