Managing Utilization under PDGM with Star Ratings in Mind

[3275] Managing Utilization under PDGM with Star Ratings in Mind
A review of how agency outcomes affects star ratings under PDGM.

Presentation Info:

• Presentation Date: August 27, 2019
• TAHC&H Event: TAHC&H Annual Meeting | Grapevine

Education-Training Credits:

• TX HCSSA Administrator/Alternate Continuing Education
• 1.5 Clock Hr(s)

HCSSA Topic(s) Addressed:

• §97.259[d][4]agency responsibilities
• §97.260[a][3]basic principles of management in a licensed health-related setting
• §97.260[a][6]risk assessment and management
• §97.260[a][7]financial management

Program Description:In this program the presenters review how agency outcomes affects star ratings under PDGM. A case study is presented focusing on care of the patient with a specific primary diagnosis and differences between caring for the patient under PPS versus PDGM. Key areas of focus will be managing inappropriate LUPAs under PDGM, cost effective approaches for improving functional status of patients under PDGM, and recommended metrics to track under PDGM.

Program Learning Outcome: Participants will actively participate in the learning activity and indicate an intent to change their practice by implementing effective clinical approaches to contribute to improved patient outcomes under the Patient Driven Groupings Model.

TAHC&H Faculty/Presenter: Christopher Attaya, Strategic Healthcare Programs & Sue Payne, RN, MBA, Corridor

About the Presenter:
Christopher Attaya joined SHP in 2014 after spending 28 years in executive and consulting positions within the Home Health and Hospice industry. In his role, he is responsible for product development and client relationships to help organizations achieve increased operational and financial performance through the use of SHP’s industry leading analytics platform and benchmark data. Prior to SHP, Chris was the CFO at the VNA of Boston and had worked at Partners Health Care at Home as CFO and CEO. He received a B.A. in Public Health from Tufts University and an M.B.A. from the Graduate School of Management at Boston University concentrating in Health Care Finance.

About the Presenter:
Sue Payne joined the Corridor team in December 2016 as part of the Transpirus acquisition where she served as the Senior Vice President of Clinical Services. In her role, Sue is responsible for clinical quality and business review to assure client satisfaction. She also serves as the Corporate Compliance Officer.

Sue has over 25 years in home care operations and strategic leadership. Prior to her role at Corridor, Sue was the Vice President of Home Health at Advanced Home Care and at Life Care at Home, both of which are multi-state home care providers. Prior to that, she was the Administrative Director at Bon Secours Home Care which is a multi-site hospital based home care agency. She has experience with hospital based, long term care and privately held home care companies. Sue was the recipient of the 2011 Leadership Award from the Association for Home & Hospice Care of North Carolina. She has presented nationally at Press Ganey, Visiting Nurses Association of America, American Congress of Healthcare Executives, and State Associations on topics such as preventing avoidable readmissions, value based purchasing, staffing retention and early careerist mentoring. She currently serves as a VNAA board member and is on the VNAA Governance Committee.
Sue has a B.S degree in Nursing from Radford University, a M.B.A from the University of Tennessee-Chattanooga and holds Certification in Home Health/Hospice from the National Association of Home Care.

[3275] Managing Utilization under PDGM with Star Ratings in Mind