Last fall, Centers for Medicare and Medicaid (CMS) announced that it would be transitioning home health agencies to the Patient-Driven Groupings Model (PDGM), which will put greater emphasis on patient needs and characteristics rather than on the amount of care.
“CMS is moving home health agencies away from a volume-based payment model and to a new value-based payment system,” the American Journal of Managed Care explains.
With the change taking effect in 2020, Axxess—a Dallas-based healthcare tech company with software solutions that help over 2 million patients nationwide—has developed a full suite of tools and interactive seminars to help its clients prepare accordingly.
With Axxess’ new tools, client agencies will be able to use their own data from the past three years to analyze PDGM’s revenue impact on specific facets of care. These clients will also be able to model key PDGM components during the intake process to determine how reimbursements may be affected.
“PDGM is the biggest regulatory change for our industry in more than 20 years, so the features we provide to help our clients prepare for the changes under the new payment model are extremely important,” Andrew Olowu, Axxess’ CTO, said in a statement. “Our in-house engineering team is proud to have developed and delivered these valuable tools to help our clients thrive under PDGM, and we’re proud to have done it earlier than all of our competitors.”
Timing is everything
Under the new change, CMS will “pay higher reimbursement rates for patients who have received institutional care in the 14 days prior to their home health admissions,” according to Home Health Care News. And, early episodes will also have a higher price tag.
“Those factors alone can make a difference of $600 or more per patient per payment episode,” Axxess told Home Health Care News.
Axxess is also providing other features in anticipation of PDGM including a new billing center, intake form updates to help train and correct documentation behavior, and a PDGM case-mix analysis tool.
In addition to its online solutions, Axxess will host a nationwide series of interactive seminars to help home health providers learn successful strategies under PDGM. The entire company has undergone training for several weeks to optimize its support for clients throughout the transition, according to Olowu.
“Our leadership in helping our clients get ready for PDGM is a continuation of the innovation leadership that drives our company every day,” he said. “We have every confidence Axxess clients will be the best prepared to thrive under the new PDGM payment model in the years ahead.”
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