The Patient-Driven Groupings Model (PDGM) is a significant change from the prospective payment model and creates new challenges for agencies. One major issue is the application of behavioral assumptions to make adjustments to rates. Making rate decisions tied to assumptions that are based on unknown future provider behavior can negatively impact home health providers and the individuals they serve.

Through these assumptions, the Centers for Medicare and Medicaid Services (CMS) is planning cuts to Medicare home health rates in 2020. Some members of Congress are working to stop these cuts and prohibit CMS from using behavioral assumptions when making rate adjustments.

Part of the OCHCH team is in Washington to advocate for you and the people you serve, but we need your help. Congress needs to hear from you! If you haven’t, take a moment and send an email to the people that represent you.