Patient Driven Groupings Model: Introduction

Patient Driven Groupings Model: Introduction 

The Centers for Medicare and Medicaid Services (CMS) will be implementing a new home health reimbursement system, Patient Driven Groupings Model (PDGM) on Jan 1, 2020. This new payment system will significantly change the way payments are delivered as well as bring along other regulatory changes. Home health care providers need to be aware of these changes and what steps they can take to meet the challenges of the new system.

$25.00

Hours: 1.50
REL-PAC-BT-PDGMI

Certificates

Certificates provided by accrediting body (9 Match)

California Board of Registered Nursing

1.5 HOURS


Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.50 contact hours for participating in this course.

American Nurses Credentialing Center

1.5 HOURS


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.50 contact hours for participating in this course.

District of Columbia Board of Nursing

1.5 HOURS


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.50 contact hours for participating in this course.

Florida Board of Nursing

1.5 HOURS


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.50 contact hours for participating in this course.

Georgia Board of Nursing

1.5 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.50 contact hours for participating in this course.

South Carolina Board of Nursing

1.5 HOURS


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

West Virginia Board of Registered Nursing

1.5 HOURS


New Mexico Board of Nursing

1.5 HOURS


New Mexico Board of Nursing (CEBroker Provider # 50-290)

This course awards 1.50 contact hours upon successful completion.

Arkansas State Board of Nursing

1.5 HOURS


Course Details

Course Code: REL-PAC-BT-PDGMI
Hours: 1.5
Type: Online Course
Content Expiration Date: 9/30/2022
Learning Objectives:
Define PDGM.
Describe at least five regulatory changes included in PDGM regulations.
Identify how PDGM changes the reimbursement methodology for home health providers.
Identify at least three operational challenges faced by home health care providers under PDGM.
Identify at least five steps home health care providers can take to prepare for PDGM.

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: What is PDGM?

PDGM: What Drove This Change?

Goal of PDGM

Impact of PDGM

Rate Setting

Review

Summary

Section 3: Home Health Resource Group (HHRG)

Timing

Admission Source

Source and Timing Case Mix Impact

Clinical Grouping

Functional

Comorbidity Adjustment

Comorbidity Adjustment Case Mix Impact

Review

Summary

Section 4: Additional PDGM Changes

LUPAs

Billing

Supplies

What Will Remain

National Impact

Estimated Impact

Review

Summary

Section 5: Preparing for PDGM

Evaluate Current Processes and Workflows

Coding

Case Management

Order Tracking

Documentation Management

Determine Estimated Revenue Impact

Educate Staff

Contact your Senators and Representatives

Review

Summary

Section 6: Conclusion

Summary

Course Contributors

Resources

References

Congratulations!

Instructor: Nick Seabrook
Nick Seabrook is a Managing Principal and Founding Partner of BlackTree Healthcare Consulting where he develops and implements the company’s strategic goals and initiatives. A Villanova University alumnus, Mr. Seabrook’s personal and professional life have been defined by passion. Whether cheering on the Wildcats, volunteering for a cause with his family, or advocating for home care and hospice agencies alongside industry leaders in Washington, he is consummately involved with his community. Notably, he is a Member of NJ Homecare Association Billing Managers Group and an Advisory Board Member of HHFMA, where he also serves as Chair for Young Professionals Committee and Chair for Payment and Reimbursement Committee. He has presented at numerous state and national conferences. Mr. Seabrook’s participation in these and many other industry forums and events over the past 19 years have garnered recognition as a leading authority on solutions to the latest operational, clinical, and regulatory challenges. BlackTree Healthcare Consulting’s mission is to be the leader in providing revenue cycle, outsourcing, and clinical consulting services for the home health, hospice, and skilled nursing industries.   Disclosure: Nick Seabrook has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Staff Writer: Jennifer W. Burks, R.N., M.S.N.

Jennifer W. Burks, R.N., M.S.N. has over 25 years of clinical and teaching experience, and her areas of expertise are critical care and home health. She earned her Bachelor of Science in Nursing from The University of Virginia in 1993 and her Master of Science in Nursing from The University of North Carolina, Greensboro in 1996. Her professional practice in education is guided by a philosophy borrowed from Florence Nightingale’s Notes on Nursing, “I do not pretend to teach her how, I ask her to teach herself, and for this purpose, I venture to give her some hints.” 

Disclosure: Jennifer W. Burks, R.N., M.S.N. has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Administrators; Nurses; in the following settings: Post-Acute Care.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.