PDGM: Components of the New Home Health Prospective Payment System

The new Patient-Driven Groupings Model (PDGM), which takes effect Jan. 1, overhauls the Medicare home health prospective payment system and requires a shift in compliance oversight.

[1] Here’s a quick summary of factors affecting groupings in PDGM.

 
1 Nina Youngstrom, “Coding, Therapy Oversight Will Shift as New HHA PPS Takes Effect Jan. 1; LUPA Changes,” Report on Medicare Compliance 28, no. 39 (November 4, 2019).

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The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

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