What is PDGM?

The Patient-Driven Groupings Model (PDGM) is a new payment model for the home health industry that relies more heavily on clinical characteristics and patient information to determine care. It eliminates the use of therapy service thresholds and changes the basic unit of home health payment from a 60-day episode to 30 days. The National Association of Home Care & Hospice calls it “the biggest change to the payment system in the 21st century.” PDGM is set to take effect Jan. 1, 2020. To help home health business stay informed, we’ve set up this page that will keep up with the latest updates. Check back frequently for more news, guidance and learning opportunities.

DALLAS (January 13, 2020)—A new industry trends report from Axxess, a home health care technology company, and BKD, a national CPA and advisory firm, confirms concern among the home-based care industry regarding implementation of the new Patient-Driven Groupings Model (PDGM) and other regulatory changes, as well as ongoing staffing challenges.

WASHINGTON, D.C. (October 30, 2019)—To allow home health agencies to transition to the Patient-Driven Groupings Model (PDGM), which becomes effective on Jan. 1, 2020, The Centers for Medicare & Medicaid Services (CMS) is rescheduling the implementation of the Home Health Review Choice Demonstration (RCD) for the remaining states of Texas, North Carolina and Florida. The demonstration is expected to begin in Texas on March 2, 2020. The choice selection period will begin on Jan.