The 2018 Proposed Home Health Payment Rule & Grouping Model

Course overview

Under HHGM, the 60-day episode of care is replaced with a 30-day period of payment and patients are placed into one of 144 payment groups. The structure of determining the payment grouping is as follows: • Admission Source & Timing (Claims) – Community Early, Community Late, Institutional Early or Institutional Late • Clinical Grouping (Primary Diagnosis) – Medication Management Teaching & Assessment (MMTA), Neuro Rehab, Wounds, Complex Nursing Interventions, Musculoskeletal (MS) Rehab, Behavioral Health • Functional Level (OASIS Items) – Low, Medium, High Comorbidity Adjustment (Secondary Diagnoses) – No or Yes • Low Utilization Payment Adjustments (LUPA) will exist in the HHGM, but there are multiple ways to calculate compared to the current standard. Join one of the nation’s leading experts on the complexities of home health payment for a 90-minute webinar to review the proposed rule and to glean talking points as you develop your own comments to the Centers for Medicare & Medicaid Services on the proposed rule.