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Realizing Facility Benefits from PDGM Changes

As of January 1, 2020, the Patient-Driven Groupings Model (PDGM) has outlined a move from the Prospective Payment System’s (PPS) 60-day episode of care to two 30-day billing periods within the 60-day episode of care. Based on the patient’s primary diagnosis, each 30-day period is grouped into one of 12 clinical groupings, one of which is wound care.

 

How Will this Affect Reimbursements?

Home health organizations have an opportunity to prepare for the new PDGM reimbursement changes by developing a wound care program that services not only patients within facilities, but also continues to treat them when they have returned home, which can help prevent complications and readmissions.

 

Kane Wound Care Works with Facilities as their Mobile Wound Care Unit

Partner with Kane Wound Care for a team of mobile, experienced specialists that will provide patients with top wound care treatments while also delivering healthcare facilities with the best clinical outcomes and lower costs of care.

 

 

Tips to Maximize Reimbursements

Institutional Referrals vs Community Referrals – The earlier a skilled nursing facility can bring in a wound care specialist to assess a patient, the sooner they can start receiving necessary treatments. Homebound patients can also get connected to a home health agency before they are discharged. It’s these situations that provide patients with easier access to wound care treatments once they are home, reducing the risks of complications and readmissions.

 

Identify Patients with Wound Care Needs within the First Billing Period – We can help facilities identify wound care patients earlier, which can potentially result in a high-quality institutional referral for a home health agency while also ensuring patients receive the care they need sooner, which can improve their comfort levels and quality of life.