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Home Health Clinicians Face PDGM Knowledge Gap

The vast majority of home health clinicians currently face a steep uphill climb when it comes to operationalizing the Patient-Driven Groupings Model (PDGM), with slightly less than eight months to go before the payment overhaul goes live, a new survey suggests.

Among its changes, PDGM uses 30-day periods as a basis for payment, with each period categorized into 432 case-mix groups for the purposes of adjusting payment. Those groups are determined by a patient’s admission source, timing, clinical grouping, functional impairment and co-morbidities, making a clinician’s coding knowhow critical to an agency’s bottom lines.

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