Therapy layoffs, conversions to part-time status and general service reductions are beginning to ramp up in the home health space, multiple professional association groups told Home Health Care News. So much so, in fact, the U.S. Centers for Medicare & Medicaid Services (CMS) may be preparing to speak up.
The current shift in how and when home health agencies deliver physical, occupational and speech therapy services begins and ends with the Patient-Driven Groupings Model (PDGM). Effective on Jan. 1, PDGM largely bases therapy reimbursement on patients’ characteristics, as opposed to the sheer amount of services delivered.
Minimizing therapy volume’s role in the reimbursement equation is an intentional effort by CMS to fix what it and others have historically seen as over-utilization. Contrary to some misconceptions, PDGM does not stop reimbursing for therapy services entirely, nor does it mean home health agencies can decline to deliver therapy service when a patient’s plan of care explicitly calls for it.