WHAT TO KNOW AND HOW TO PREPARE
PDGM - Solved
Better Data. Better Insights.
Are you ready for Patient-Driven Groupings Model (PDGM)? What effect will PDGM have on your agency and how can you strategically plan and prepare? The key to success with PDGM is to have real-time data that is constantly pushed to you, which will give you the needed advantage to thrive with the PDGM model.
SIDE BY SIDE ANALYSIS
How Better Preparation Happens.
Compare a patient under the current PPS model to that same patient on January 1, 2020 under the PDGM model.
- REVENUE ANALYSIS
- HHRG CALCULATIONS
- LUPA THRESHOLD
- VISIT UTILIZATION
- PRIMARY DIAGNOSIS
- SECONDARY DIAGNOSIS
Total revenue under PDGM for the 60-day episode.
Overview of the elements that make up the HHRG are calculated i.e. source/timing, clinical group, functional impairment level, comorbidity adjustment, HIPPS code, wage index, case-mix weight.
Reimbursement amount for each 30-day period with care type.
LUPA threshold calculated for each 30-day period and warning if your current planned visits will not meet the LUPA threshold.
Visit utilization planned/actual for each discipline listed with total.
Specific primary diagnosis information with the clinical group listed and a warning if the diagnosis does not fall into one of the 12 clinical groups. A warning indicates you are at risk that the claim will be returned to provider for more specific coding.
Up to 24 secondary diagnosis codes with comorbidity subgroup listed and calculated based on the number of diagnosis that fall into one of the approved groups. There are 3 levels of comorbidity adjustment (none, low, high).
Real-Time PDGM Workflow Information
Get real-time comprehensive information and alerts to ensure you are able to manage the PDGM workflow. The KanTime PDGM specific dashboard will provide you with real-time comprehensive information and alerts to ensure you are able to manage the PDGM workflow. Each dashboard widget and counter will allow the user to monitor and act on key elements related to PDGM as needed to ensure quality care for the patient and timely processing of claims.
See patients who are affected by PDGM, at high risk for fall or re-hospitalization, pending evaluations by other disciplines.
Review patients that fall into each clinical grouping.
Metrics that help monitor efficiencies and workflow problems for days to admission and evaluation, days to assessment locking.
Get alerts for non-qualified diagnoses, potential LUPAs, assessments not locked or orders not signed.
Coordinate care for multiple discipline patients and those without care coordination notes.
Monitor and track orders not sent, outstanding orders, and physician portal orders.
Analyze financial metrics such as cost per episode/visit, time for RAP and claim.
Identify institutional vs community referrals to see where marketing efforts are best utilized.