Talk Ten Tuesdays

2020 Changes in Risk-Adjusted Reimbursement

April 09, 2019 Chuck Buck | Timothy Powell, CPA |Laurie M. Johnson | Glenn Krauss | Bonnie S. Cassidy| Erica Remer, MD Episode 364
Talk Ten Tuesdays
2020 Changes in Risk-Adjusted Reimbursement
Show Notes

What’s next, when it comes to risk-adjusted reimbursement?  

Home health is next. Just like diagnosis-related groups (DRGs) and hierarchical condition categories (HCCs), the patient-driven groupings model (PDGM) represents another tremendous opportunity for the health information management (HIM) professional because of the nationwide demands for ICD-10 expertise.  

The Centers for Medicare & Medicaid Services (CMS) is moving home health agencies away from a volume-based payment model and toward this new value-based payment system. During this edition of Talk Ten Tuesdays, where we hear from Bonnie S. Cassidy, past president of the American Health Information Management Association (AHIMA), who will share important news on the PDGM program. 

The broadcast will also feature these other segments:

  • CDI Report: Glenn Krauss, nationally recognized clinical documentation improvement (CDI) expert, reports on the top 25 DRGs with improper payment due to insufficient documentation, medical necessity, and coding – and how while optimization through queries might help, the bottom line is getting paid.

  • News Desk: Timothy Powell, a compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.

  • Coding Report: Senior healthcare consultant Laurie Johnson returns to the broadcast to report on the diseases and the corresponding codes that are making the news.

  • TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on the development of the DRG: the backbone of the current prospective payment system.

Materials from Dr. Remer's segment