BlackTree Healthcare Consulting

BlackTree, Simione Unveil ‘SimiTree’ Following Private Equity-Backed Merger

The post-acute care space has been undergoing a wave of consolidation for the past few years. And as more providers come together, the businesses that serve them are beginning to do the same. The newest example of that trend came Tuesday, when the Connecticut-based Simione Healthcare Consultants and Pennsylvania-based BlackTree Healthcare Consulting revealed plans to …

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Home Health LUPA Challenges Continue as Pandemic Subsides

The frequency of low-utilization payment adjustments (LUPAs) increased for many home health providers in the first year of the Patient-Driven Groupings Model (PDGM), which coincided with the COVID-19 crisis. In part, that’s because there are far more LUPA variables to keep track of under the new payment model. At times, increases were also linked to …

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CMS Could Target LUPAs, Functional Impairment in Future PDGM Adjustments

Despite the once-in-a-generation COVID-19 pandemic, the home health industry’s transition to the Patient-Driven Groupings Model (PDGM) was pretty seamless. Looking into the not-too-distant future, the U.S. Centers for Medicare & Medicaid Services (CMS) will now likely attempt to make modest tweaks to a handful of key areas, payment experts believe. The agency will do so …

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Home Health Experts Offer Update on Transition to No-Pay RAPs

It’s been 48 days since the start of “no-pay RAPs” in home health care. During this time, providers have had to navigate a sea of challenges and unexpected speed bumps while adjusting to the new process. The U.S. Centers for Medicare & Medicaid Services (CMS) kicked off no-pay RAPs on Jan. 1 of this year. …

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Home Health Therapy Utilization Increased Under PDGM, New Data Suggests

The Patient-Driven Groupings Model (PDGM) has finally been around long enough for there to be some legitimate and meaningful data. The COVID-19 crisis has obscured some of the numbers, but the home health world is finally gaining a clearer picture on what kind of impact the new payment model has had since its Jan. 1, …

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Debunking Common PDGM Primary Diagnosis Myths

In order for home health providers to see reimbursement success, they need to be able to separate myths from facts when it comes to the Patient-Driven Groupings Model (PDGM). But one specific point of confusion has been primary diagnosis clinical groups. “There are a lot of rumors and myths floating around out there,” Robbi D. …

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Assisted Living Facilities Still Restricting Home Health Providers

Home health providers have been on the front lines of the COVID-19 crisis since its outset, yet a primary concern remains being left behind by legislators, whether that’s on a state or federal level. Reimbursement for telehealth services is still on the forefront of everyone’s minds. But there are less-covered issues that haunt providers as …

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Elara Caring Targets Physicians as Home Health Providers Rethink Referrals

In the build-up to 2020 and the Patient-Driven Groupings Model (PDGM), many home health providers began shifting their referral strategies to focus more on hospitals, skilled nursing facilities (SNFs) and other institutional sources. Generally, providers realized that patients coming from such settings likely meant more Medicare dollars under PDGM, especially when patients were also classified …

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Early Data Shows PDGM’s Regional Winners, Losers 

The impact of the Patient-Driven Groupings Model (PDGM) doesn’t appear to be universal. In fact, each home health care agency’s performance under the model seems to depend on a few somewhat uncontrollable factors, new PDGM data suggests. “CMS created a model that was based on all claims nationally, but depending on where you are and …

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PDGM Data Shows Reality-Versus-Expectations Mismatch for Case-Mix Components

The Centers for Medicare & Medicaid Services (CMS) was a little bit off with some of its predictions related to the Patient-Driven Groupings Model (PDGM).  At least, that’s true when it comes to the first four months of 2020, according to Strategic Healthcare Programs (SHP) data unveiled on a recent BlackTree Healthcare Consulting webinar. The …

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Home Health Cash Flow Has Yet to Recover from Post-PDGM Dip

Even before the coronavirus hit, cash flow was poised to be a problem for home health providers in 2020. The Patient-Driven Groupings Model (PDGM) shortened home health billing periods from 60 days to 30, creating a cash flow crunch for agencies during their first few months under the new model, which took effect Jan. 1. …

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