PDGM Beyond the Basics: Clinical Grouping and Co-Morbidity Adjustments

Course overview

The Patient-Driven Groupings Model (PDGM) is the most significant change to the home health payment reform in the past two decades. The impact from PDGM is expected to significantly shift service delivery and will change the structure of home health reimbursements. Two key components for calculating payment under PDGM will be clinical group assignment and comorbidity adjustment, thus making ICD-10 coding more important than ever. The need for specific diagnoses is not limited to the primary diagnosis section. PDGM introduces a co-morbidity adjustment that is calculated from up to 24 diagnoses that follow the primary reason home care is tracking the patient. The co-morbidity adjustment can increase reimbursement up to 20%. Specificity and accuracy in ICD-10 will be critical. The long-held practice of accepting whatever patient information physicians deem to send agencies for referrals - because thats all they have, will no longer be an option under PDGM. Join the experts from BlackTree Healthcare Consulting as they take a deeper dive into the detail of PDGM clinical groupings and co-morbidity adjustments. This training will provide participants with a deeper understanding of the challenges agencies will face with these two key components in PDGM and how best to prepare for a smooth transition.