Kenyon HomeCare ConsultingCombing Through The 2019/2020 Home Health Payment Rule Changes Without Pulling Your Hair Out! - Kenyon HomeCare Consulting (206) 721-5091

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Combing Through The 2019/2020 Home Health Payment Rule Changes Without Pulling Your Hair Out!

healthcare reformWhenever CMS drops payment changes, home health agencies want to cringe. Over the years, agencies become better at completing documentation and filling out Oasis properly. In response, CMS hits us with terms like case mix creep and then  changes payment for services. It can be overwhelming to jump multiple hurdles and not feel like you reach the finish line. Let’s look at payment and policy reform and how it changes care planning. 

Per CMS: 

CMS states policy changes for 2019 are based upon empowering patients, increasing competition, and fostering innovation.  The goal here is that the changes are supposed to be less about paperwork and more about patient focus. Focus on the condition/needs of the patient and not on the amount of care provided. This is the continued evolution of a value-based purchasing model with advancement of quality reporting. 

30-Day Periods In A 60 Day POC: 

This is a huge stand out for providers. Ultimately, instead of the 60-day episode of care, CMS will begin paying according to 30-day periods. This is a budget neutral plan from CMS to begin calendar year 2020. The therapy thresholds will be gone then as well. If you follow the rationale from CMS, then it makes sense. Value-based purchasing and episodic care are not meant to be based on the volume of visits. However, therapy thresholds are. So, your efforts to push therapy providers to work together in an interdisciplinary manner is not in vain. It is necessity. 

What Does PDGM Ultimately Mean: 

It means you must see each discipline working collectively. Weekly goals are discussed between disciplines and all members know exactly what to work on in the patient care plan that week. Then, progression of care is a systematic effort focused on joint goals. Now, this does not mean everything is going to be easy. If you thought so, you wouldn’t be in home health right now. Correct? Well, in all honestly, this is absolutely the time to advance home health into the next realm of care. This is front-loading of care from all disciplines. It is making the Oasis something you learn from as opposed to a form that must be filled out for payment. It is making the medical home model reality for all home care providers.

Kenyon Homecare Consulting Can Help: 

At Kenyon Homecare Consulting, we are working through these changes with agencies along with you. The senior consulting staff can help you move through operational changes to match the industry standard of care. As we continue to focus on aspects of payment reform, please call us at 206-721-5091 or contact us online to see if we can help you meet your goals.

Category: Legislation/Reform, Regulatory Compliance

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