The PointClickCare Home Health Care solution will make your business run more smoothly and it will be a better operation moving forward.
Greg Von Arx
Chief Executive Officer
Recover Health, Inc.
“It takes a long time to move a big ship. By having access to the data early on, thanks to PointClickCare, we were able to put plans in place and respond in ways that had positive clinical and financial impacts.“
My name is Greg Von Arx and I’m the CEO for Recover Health, Inc. We are a home health agency that provides a full range of home health care services, including skilled nursing, physical, occupational, and speech therapy. Recover Health has 31 locations across the U.S. Midwest. Our mission is to create relationships that make a meaningful difference in people’s lives.
Preparing for PDGM
When preparing for the Patient-Driven Groupings Model (PDGM), we had a lot of concerns about how our agency would perform. CMS had a before and after calculation that they set up for most clients, and we were looking at an 8 percent reduction in revenue. That equated to almost 2 million dollars for us.
Using the data that was available in PointClickCare, we were able to set up a report that would allow us to see the PDGM values compared to the values under prospective payment system (PPS). Thanks to that data, we learned that if we continued as usual, we would frequently miss the second 30‐day payment, causing a substantial reduction in our revenue. We knew we needed to extend our time in the homes, and we put a plan in place to do that. Those changes led to longer lengths of stay, with our nursing visits in a 60‐day period increasing to 4.7 visits, therapy visits dropping by 2 visits in a 60‐day period, and our 60‐day payment value increased by over $700. We managed to accomplish exactly what CMS wanted us to do. We increased our nursing visits, decreased our therapy visits slightly, and we now have a better clinical outcome.
Transitioning to a New Payment Model
As our agency transitioned to PDGM, we knew that around 20 percent of the ICD 10 codes under PPS would not be an allowable code under the new payment model. Under PDGM, it’s called a questionable encounter (QE). So, we chose to focus on our QEs very early as we prepared for the changes. It’s great data, and it all comes from the PointClickCare system. The data that was available in the system allowed us to focus on multiple items related to improving our business during the transition to the new payment model. In the end, there were two major focuses that have allowed us to improve our margins and clinical outcomes, which were extending the period to get to the second 30-day payment period and focusing on eliminating QE’s (using valid ICD 10 codes).
PointClickCare Provided Us With the Right Data
PointClickCare’s agility to get after the PDGM calculating immediately, allowed us enough time to prepare. It takes a long time to move a big ship. By having access to the data early on, thanks to PointClickCare jumping on the PDGM bandwagon early, we were able to put plans in place and respond in ways that had positive clinical and financial impacts.
We have a lot of different payors and products, and PointClickCare is flexible enough to handle all of those variations. The PointClickCare Home Health Care solution will make your business run more smoothly and it will be a better operation moving forward.