As our healthcare heroes work around the clock during the COVID-19 pandemic, the IT systems that support them are also being put to the test. Healthcare organizations are expanding their networks to support additional clinics, labs and testing facilities. More medical devices are connecting to the network, as well as the smartphones, tablets and wearables of clinicians, staff and patients. Employees who can work from home are connecting to systems remotely.
In our last post we discussed the Patient Driven Groupings Model (PDGM), an overhaul of the way home health providers are paid by the Centers for Medicare and Medicaid Services (CMS). The new billing model creates hundreds of new categories for home health services, and implements a 30-day billing cycle to replace the current 60-day cycle. It also changes the way providers are assessed Low Utilization Payment Adjustments (LUPAs), and uses “behavioral assumptions” to identify providers that might structure services to maximize billing.