PDGM National Summit in the Rockies

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.

Objectives

• Identify the structural framework of PDGM in comparison to the current payment model, HH PPS.
• Explain the rational behind the PDGM changes
• Identify the concerns and opportunities in PDGM along with ongoing PDGM reform efforts.

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.

Objectives
•        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

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.

Objectives
•        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.

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.

Objectives:

• 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

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.

Objectives
•        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

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.  

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

We bring together all of 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/.attendees open forum.