PDGM: Please Don’t Get Mad
Healthcare is interesting! While evolving with technology, services, professions, and systems, cost and reimbursement find themselves consistently under fire. Some may say that United States Healthcare System is broken, some may say it works, but, regardless, it is changing! Some of the most recent changes were implemented in October and January, including models coined as Patient Driven. At first glance, they don’t seem too bad, but after further review, they pose a number of challenges for both patients and providers!
PDGM, or Patient-Driven Groupings Model, was rolled out on January 1st for all home healthcare providers and patients with Medicare Part A insurance. While being phrased as Patient-Driven, it actually limits access to care! Your initial reaction may be… WHAT? HOW COULD THEY DO THAT? And while you’re not wrong (we had the same reaction!), we chose to stay dynamic and pivot in the changing times to ensure consistent access to quality care. Our solution was designed to reduce gaps in care and assist with transitions from an inpatient setting (hospital, rehab, etc…) to home (home health or house calls) to the outpatient setting (outpatient clinics or house calls).
THE FULL RANGE PPM SYSTEM:
Step One:
Discharge from an inpatient setting is pending, or you rely heavily on someone else to help you out of the house. This is where our home health division comes in. With the goal of STABILIZING, we work with you and your family to ensure a safe transition and home set up. Services may include nursing, physical therapy, occupational therapy, speech therapy, social work, and home health aide. Assistance with medications, wounds, falls, equipment, balance, strength, endurance, and much more is available!
Step Two:
Discharge from home health is pending and you are able to get in and out of your home without assistance. OR, you are progressing and are now stable with your new medications, recent surgery, new diagnosis, etc…. This is where outpatient services come in! With the goal of MAXIMIZING, we work with you to help you reach your goals and live life your way! Our slogan “YOUR LIFE. YOUR GOALS. YOUR WAY.” is what it is all about! Helping you do the things you love! We design a plan of care around you! This plan could be in home through our house call team or in one of our local outpatient clinics! Both are outpatient services delivered on an individualized basis to help you reach your goals.
Step Three:
Worried about the next step and what happens if….? The “what if’s” of life can be daunting and we understand this! Fear of falling or getting worse is a very real thing! Our Therapy Care Management program was designed for just that! We will stop in for a visit once a month (about every 4 weeks) following your discharge from outpatient services. Simple as that! We stop in for a check-up, including vital signs, medications, physical ability, and more! Not too intrusive, but enough to give you the confidence that things are going well! Afterall, our mind is a very powerful thing and confidence goes a LONG way!
What is all of this about?
This is our way of doing our part! We choose YOU! We choose to help and serve in any way we can. Our model of progression, prevention, and maintenance (or PPM) is our innovative way of ensuring that you have access to the care you need (or the care your patients/clients need)!
Next steps?
Give us a call or email to learn more! We’d love to hear from you and are ready to help wherever we can!
Call us at 610-241-2685
Email: [email protected]