The Facts About Upcoming Changes in Home Health Payment: Here's what's true about the Patient-Driven Groupings Model-and what's not.

HOME care services; POLICY sciences; HEALTH insurance reimbursement; RULES; PROSPECTIVE payment systems; CENTERS for Medicare & Medicaid Services (U.S.); ECONOMICS

The article discusses updates as of May 2019, to the case mix methodology and payment system for home health agencies (HHA) under Medicare's Patient-Driven Groupings Model (PDGM) and how it will affect physical therapists. Topics discussed include key provisions of the PDGM as basis for payment and updates on low utilization payment adjustment (LUPA) thresholds. Also mentioned are myths and realities related to access concerns that threaten the long term success of PDGM.