Hospitals made the change from volume to value by decreasing the length of patient’s hospital stays, using DRG’s, and abiding by standards like penalties for 30-day readmissions. Because of Medicare’s success in the acute space, it was only a matter of time till these changes filtered down into post-acute care.
While HHGM has yet to be finalized, high performing agencies have been unknowingly working to incorporate HHGM standards, a little at a time, for years. HHGM will likely have a positive effect on revenue for these agencies. Conversely, agencies holding onto the legacy practices of the last 20 years are already behind. The final rule stated CMS is holding off on making HHGM final for now, but insiders agree - it is still coming.
CMS has been “herding” home health into this model for several years. Regulation and program changes have slowly guided agencies to change their practices—mostly by incentive, and finally by penalty or audit.
If your agency is part of the “herd” implementing changes over the last few years, congratulations, you are on the right track… if not, you have some catching up to do, but CMS is herding you in the right direction. All you have to do is follow!
Kristi Bajer is the VP of Clinical Operations at OperaCare LLC. A data driven automated QA platform which ensures compliance and revenue integrity.