Webinar - PDGM 2020 Virtual Summit
April 28, 2020
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PDGM is HERE!
Success Comes From Continuous Operational Improvements: Lessons Learned in PDGM 2020 Q1
The Patient-Driven Groupings Model (PDGM) represents the most significant change in the Medicare home health program in the 21st Century. It radically changes the Medicare payment methodology, including the unit of payment, the case mix adjuster, Low Utilization Payment Adjustment standards, and payment for Non-Routine Medical Supplies.
Beginning in January 2020, the National Association for Home Care & Hospice (NAHC), in partnership with the NAHC Forum of State Associations, the Home Care & Hospice Financial Managers Association, and the Home Care Technology Association of America, will present two significant educational campaigns designed to enable home health agencies to achieve “high performer” status through continuous operational improvements in financial, clinical, business analytics, and administrative operations as PDGM unfolds.
The first educational campaign will be a series of six free webinars, beginning in late January, that address a variety of PDGM-essential topics, combined with an open forum where participants share and gain insights with HHFMA experts about what is working and not working in the early weeks of PDGM.
The second educational campaign will be a series of 12 one-day intensive Summits across the country, from March 30 through April 14. These Summits will focus on PDGM-related continuous performance improvement in financial, clinical, data analytics, and administrative operations. These are not “run-of-the-mill” PDGM programs. Instead, these programs are based on real-time, nationwide experiences and data that provide the nationally-renowned expert faculty with the deepest understanding about how to achieve success in PDGM.
Comparable in format to the intensely valuable 2019 Summits, the 2020 PDGM National Summits will be your key to thriving under PDGM. The major difference is that we are now in PDGM and will have the experiences and data to fully discern the ingredients to success.
Faculty for these one-day programs once again will be comprised of leading national experts from top home health consulting firms who will provide you with the tools and knowledge to:
- Gain a better understanding of what it takes to be a winner in PDGM;
- Identify key steps that are proving successful in managing services under PDGM;
- Recognize the actions that create unnecessary risks for your HHA; and
- Determine the early clinical and financial benchmarks that distinguish the successful HHA from others.
Attending one of these summits will fully prepare you to undertake any needed course corrections in your PDGM management, along with reinforcing the actions that you have already taken to ensure a positive outcome throughout 2020 and beyon
8:30am – 9:00am Overview
9:00am – 10:15am Operations
PDGM has required HHAs to examine overall operations structure and day-to-day management. Changes were needed throughout HHAs to meet the demands of PDGM. HHAs must quickly determine what is working and what is falling short of their expectations. Any needed modifications in operations must be put in place sooner rather than later to thrive under PDGM. Operational areas most affected by PDGM include referral and sales management, intake, revenue cycle, operational reporting, and order and supply management. Change management must be handled throughout your organization. This session focuses on the operational practices that have demonstrated early success and long-term potential for fully positive outcomes.
- Outline the operational changes that are showing reliable signs of early success and those that are not working as hoped;
- Define key areas of operations that are showing the greatest need for additional changes and how to initiate that change; and
- Identify new skill sets needed in HHA management triggered by lessons learned in PDGM Q1.
10:15am – 10:30am Break
10:30am – 12:00pm Clinical
PDGM has triggered a re-examination of clinical practices within HHAs nationwide. Documentation, diagnosis coding, care planning and care coordination are at the top of the list of best practice clinical strategies that have been employed. Are your changes resulting in the best outcomes? This session focuses on the lessons learned in Q1 in blending clinical practice and financial management to achieve the best patient and business outcomes in the new world created by PDGM.
- Describe how interdisciplinary care planning achieves cost effective and appropriate skill mix, including therapy utilization under the PDGM;
- Evaluate the impact of how changing case mix affects resource and skill set needs in your organization;
- Identify the best practice clinical strategies for managing LUPA thresholds and 30-day unit as defined by PDGM;
- Recognize essential steps to success in documentation acquisition and management to support an accurate primary diagnosis and timely claim submission; and
- Define the Clinical Manager role in the Clinical Team’s success under PDGM, including the significance of effective case conferencing and case management.
12:00pm – 12:30pm Lunch Break
12:30pm – 1:45pm Financial
Thriving (or even surviving) under the PDGM payment reform requires a clear understanding of how PDGM is affecting the financial outcomes of a home health agency. This session explores the fundamental steps necessary for home health agencies to assess whether the initiatives taken to prepare for PDGM are in place and working, the options for mid-course corrections in PDGM financial management, trends in the impact of PDGM, cash flow remedies, and planning for 2021.
- Measure the early trends in PDGM financial impact on your organization including cash flow management under the new RAP model;
- Recognize how to determine whether your revenue cycle management fits your agency under PDGM and what steps are needed to bring it to top performance; and
- Identify clinical and operational practices that lead to the most favorable financial outcome under PDGM.
1:45pm – 2:00pm Break
2:00pm – 3:15pm Business Analytics
Increasingly, HHAs are recognizing the value of robust reliable business analytics in managing the change to PDGM. Real time data availability and early analysis of the key performance indicators in PDGM are important ingredients to early success in PDGM. This program is a deep dive into the early key data analytics that can help define whether your organization is on track for PDGM success or whether corrective action is needed. Through the assistance of IT and EMR partners across the country, this program will offer an intensely valuable first look at PDGM action and outcomes within the overall HHA community. That impact analysis and useful benchmark data can help guide your agency to success in CY 2020 and beyond.
- Achieve meaningful insights on clinical categories, utilization and other characteristics using claims data from PDGM Q1;
- Provide data drill downs on LUPA, lengths of stay and other operational metrics under PDGM Q1; and
- Obtain the insights needed to connect the data analytics tools to operational, clinical, and financial actions needed to ensure maximum value and PDGM success.
3:15pm – 4:30pm Open Forum
Leading Industry Experts - TBA
Workshop Fees: If your agency is a member of NAHC or a Non-Host State, you will need to contact HCLA to receive the member rate.
|HCLA and NAHC Members