PDGM Workgroup, Including QIRT Executives, Submit an Advisory Letter to CMS

QIRT is working tirelessly to support agencies in advance of the PDGM transition. Recently, PDGM Workgroup, including QIRT executives, submitted an Advisory Letter to Centers for Medicare & Medicaid Services (CMS). On or after January 1, 2020, the payment system for home health agencies will be changing from the Home Health Prospective Payment System (HH PPS) to the Patient-Driven Groupings Model (PDGM). Consequently, PDGM will result in a significant workflow and process change that has raised concerns within the industry. As such, the PDGM Workgroup’s letter is intended to ensure that the transition does not have a deleterious impact on home health agencies.

UPDATE:

In a reply email on June 14, CMS thanked the PDGM Workgroup for “taking a deep dive into the PDGM and for sharing your expertise” and expressed gratitude to the Workgroup for bringing their concerns to CMS’ attention. Due to the size and scope of the concerns, CMS indicated the concerns will take some time to evaluate. Thank you to CMS for your time and consideration.


The PDGM Workgroup’s letter is intended to ensure that the transition does not have a deleterious impact on home health agencies.

In a press release, QIRT President/CEO Laura Page-Greifinger was quoted as saying: “Drawing on my years of experience in the industry, I agree that it is appropriate to see the patient placed at the center of care. Value-based outcomes per agency will become clearly evident with PDGM. Accurate coding to arrive at the primary diagnosis and co-morbidities of each individual patient is necessary to reflect the severity of the patient condition, reduce the number of claims being returned to providers, and to capture population health data based upon patient characteristics. The QIRT Team will continue to advise the industry to prepare ahead of time with best practices to accommodate the changes in functions of the agency that PDGM will bring. QIRT welcomes this challenge and will work tirelessly to help agencies prepare for and thrive in this new payment model.” 

Read the original PDGM Workgroup letter here.

Find the 6/12/29 press release here.

Support from QIRT

In the new payment model, accurate coding and OASIS, coupled with fast turnaround times will make all the difference for success of an agency. QIRT experts are available to help agencies prepare for the transition. For more information, visit our website or email QIRT today.

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