SEATTLE (October 14, 2019) –PointClickCare, a software vendor for the senior care market, announced efforts to help homecare providers effectively prepare for an evolving value-based payment environment, including the Patient Driven Groupings Model (PDGM). Since last November, when the new case-mix classification model was announced, PointClickCare has been continuously evolving its home care solution, as well as developing resources and tools to help providers manage the change to PDGM with confidence.

“With a fast approaching deadline to comply with PDGM, almost every provider is evaluating its PDGM preparedness strategy and readiness,” says Mark Tomzak, vice-president and general manager of Home Care, PointClickCare. “PointClickCare is fully committed to ensuring that its platform and solutions are evolving to help customers maintain regulatory compliance in a timely manner.”

When PDGM goes into effect on Jan. 1, 2020, homecare providers using PointClickCare’s home care platform will be able to: 

  • Streamline their path to revenue and reduce days to bill with efficient billing of two RAPs and Finals for each 60-day episode of care
  • Improve communication and collaboration with dashboards that reduce back-and-forth pre-billing requirement communication
  • Reduce days sales outstanding with automated workflows for monitoring requirements, generating and submitting claims, and auto-posting cash receipts
  • Improve compliance and reduce returned claims with automated validation of payer requirements
  • Monitor low-utilization payment adjustments (LUPA) percentage and track LUPA thresholds per clinical grouping and 30-day billing period
  • Provide a comparison of the case-mix reimbursement impact under the current PPS model versus what is projected under PDGM. 
  • Show agencies the LUPA thresholds for each of the two 30-day billing periods prior to locking the OASIS or Plan of Care. 
  • Use the intake workflow to document timing, admission information, and pull pertinent patient data from the patient’s SNF chart to the Home Health chart. to help reduce days to Admission. 
  • Identify which of the 12 clinical groupings the primary diagnosis corresponds to, to help guide care teams to the most appropriate diagnosis and prevent unacceptable primary diagnosis codes. 
  • Integrate with an automated Order Tracking system to send, manage and roundtrip physician orders to the doctor and back into the patient chart. 

In addition to platform enhancements, to help providers perform under PDGM, PointClickCare has developed a library of digital resources and tools accessible to all providers. This includes a series of webinars, eBooks, and a ‘PDGM Calculator’ that aggregates CMS’s Agency-Level Impact information for calendar year 2019.

To learn more about how PointClickCare is preparing home care providers for confidence under PDGM, visit our dedicated team at booth #209 at the NAHC Home Care and Hospice Conference, or visit