Credit, Billing Staff Are Keys to a Smooth Financial Transition into PDGM

When the Patient-Driven Groupings Model (PDGM) takes effect Jan. 1, home health care billing processes will become significantly more complicated. The new model revolutionizes the way agencies are reimbursed, cutting payment periods in half and requiring more detailed claims, among other changes.

As a result, PDGM will likely put financial strain on even the most prepared agencies in the early months of its implementation, during which cash flow is likely to dip. As such, it’s vital for agencies to establish credit lines and update their billing processes to stay afloat, financial experts caution.

“I don’t think there’s an option to not be prepared if one wants to stay in business and care for patients,” Misty Skinner, executive vice president of services for HEALTHCAREfirst, told Home Health Care News. “If everything goes perfectly as it should — and it won’t — there’s going to be financial pressure. Be ready for that.”