The change from PPS to PDGM (Patient Driven Grouping Model) will be as significant of a change for home health as the change from IPS to PPS was. Many agencies will see a reduction in payment and need to understand what changes need to be completed in the agency structure so that they will be able to survive the switch to this new payment method.
- Verbalize the changes in PDGM from PPS
- Discuss the changes in coding practices that will be required to successfully survive under PDGM
- Understand the difference between unspecified and specific diagnosis codes
- Describe the differences between primary and supporting diagnosis codes and how they affect payment under PDGM
- Demonstrate the changes in resource utilization that will be necessary to maximize payment under PDGM.
Michael Tidd has over 19 years of experience in the Home Care Industry and is a frequent speaker at HealthCare Synergy Workshops and Webinars. He is a Software Developer, LVN and Certified in ICD-9/10 Coding and OASIS (COS-C, HCS-D). As the Clinical Manager for HealthCare Synergy, he directs the Outsourced Management Services, assists in directing the development of the Healthcare Assistant Web Edition, oversees the Clinical Documentation Auditing provided to clients and directs the Clinical Form Development for the Healthcare Assistant Web Edition. Michael continues to educate agencies in the ongoing regulations that CMS produces, the proper application of the Medicare Conditions of Participation and completing timely, accurate and defendable clinical documentation to survive in the current Medicare Reimbursement Model.