Our weekly list of news, reports, and information about home health and hospice care. Learn about new studies, trends, CMS regulations and more.
Like so many others in the industry, the Patient-Driven Groupings Model (PDGM) remains top of mind for Baton Rouge, Louisiana-based home health giant Amedisys Inc. (Nasdaq: AMED). Unsurprisingly, navigating the payment overhaul remains one of the company’s biggest priorities moving forward into 2020. Building out its hospice business and expanding its personal care network with ClearCare Inc. are also key areas of focus, according to Amedisys President and CEO Paul Kusserow. “Internally, we have been practicing and drilling for PDGM since November 2018, when [the Centers for Medicare & Medicaid Services] (CMS) finalized the 2019 rule with the new payment model,” Kusserow said during a Wednesday third-quarter earnings call. “Since then, we’ve had a cross-functional team of over 40 of our best [staff members] working daily to prepare our business for these pending changes.”
The Centers for Medicare & Medicaid Services (CMS) on Thursday finalized the Patient-Driven Groupings Model (PDGM) for 2020, in addition to its plan to phase out home health pre-payments and introduce a new home infusion therapy benefit. But perhaps the biggest news for U.S. home health providers is a major update to PDGM’s widely opposed and controversial behavioral adjustment. Broadly, the assumption-based behavioral adjustment is built on CMS’s belief that agencies will automatically change their coding and visit behavior in order to maximize reimbursement under the looming payment overhaul.
The Centers for Medicare & Medicaid Services (CMS) shouldn’t risk home health industry destabilization while pushing through its proposed version of the Patient-Driven Groupings Model (PDGM), especially when it comes to the overhaul’s looming 8.01% behavioral adjustment. That’s according to Encompass Health Corporation (NYSE: EHC) President and CEO Mark Tarr, who discussed PDGM and his company’s preparation plans Tuesday morning during a 2019 third-quarter earnings call. Instead of the immediate hit, the CEO argued, CMS should consider scrapping the assumption-based behavioral adjustment all together — or at least spread it out over multiple years.
U.S. Hospice Care Market Size with Global Investment, Top Companies Analysis, New Business Developments and Forecast 2026
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