Patient-Driven Groupings Model Mini Conference


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 January 1, 2020. You cannot afford to miss it!

Program Topics:

A variety of topics will be addressed including a PDGM Overview, Clinical, Coding, Financial, Operations, and Business Analytics, you will:

    Outline the structure of PDGM and key points affecting you and your agency and the industry at large
    Develop a plan to control the impact of PDGM on your agency
    Measure the financial impact on your organization
    Outline how PDGM will require agencies to consider process changes in their business operations
    Understand the PDGM impact on OASIS-D and ICD-10 coding
    Detail the ICD-10 coding impact on the Home Health Resource Group (HHRG) under PDGM


Day 1 Overview - Financial/Operations/Data Analytics

This comprehensive day of The Patient Driven Groupings Model (PDGM) is going to give agencies the biggest and best chance to fully understand the changes and confirm the need for additional changes within their agencies.  This workshop provides a quick overview of the PDGM structure and operation along with a review of the concerns and opportunities triggered by PDGM. The Financial portion of the workshop will assist agencies in monitoring their impact and analyzing what will be necessary to adjust.  Two key components will include revenue estimates and cash flow.  Operations will include operational decisions primarily regarding the Revenue Cycle and operational reporting, which will cover cost containment.  Data drill downs on overall expectations of number of 30-day payment periods, LUPA statistics.

  • Identify the structural framework of PDGM and the concerns and opportunities in PDGM
  • Measure the financial impact on your organization
  • Define how PDGM will impact Revenue Cycle and what you should do to adapt
  • Outline how PDGM will require agencies to consider process changes in their business operations
  • Identify recommendations and strategies for process adjustments to achieve a successful operational transition to PDGM
  • Provide data drill downs on LUPA, lengths of stay and other operational metrics
  • Review tools and Key Performance Indicators to help prepare and run your agencies
Day 2 Overview - Clinical & Coding

The implementation of PDGM will bring many challenges that agencies will face from a clinical and coding aspect.  This comprehensive day of education will focus on documentation, care planning and appropriate ICD-10 coding as the top best practices imperative for agencies to grasp.  At the heart of PDGM is the fact that ICD-10 coding will be the sole source of the clinical grouping of the patient, as well as the co-morbidity adjustment.  This workshop will dive deep into the allowable primary diagnoses and co-morbidity categories.  OASIS-D will drive the functional portion of the case-mix grouping and must be given undeniable attention.  This workshop is imperative for your agency’s success.  

  • Outline the OASIS-D ADL Section and grouping effect.
  • Detail ICD-10 Coding Impact on the Home Health Resource Group (HHRG) under PDGM.
  • Define the process and documentation requirements for establishing the primary and secondary diagnoses of the patient.
  • Describe how interdisciplinary care planning can manage cost effective and appropriate skill mix, including therapy utilization under the PDGM.
  • Review best practice clinical strategies for managing LUPA thresholds as defined by PDGM.


    Data Analytics, Financial & Operations Speaker
    Melinda Gaboury, COS-C - Healthcare Provider Solutions

    Clinical & Coding Speaker
    Sharon Litwin, RN, BSHS, MHA - 5 Star Consultants, Inc.


    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.


    Provider approved by the California Board of Registered Nursing (Provider #CEP2463) for ten (10) contact hours of continuing education. You must be present for the entire workshop to earn Continuing Education Units. Certificates are distributed at the close of the program. No partial credits can be given.