PATIENT ACUITY in the "new" PPS is a chief concern for your agency. The greater the Home Health Resource Group (HHRG), the larger payment your agency can receive. Some administrators are pushing clinicians to add more case-mix points. But clinicians cannot do this - they cannot change what a patient is. However, by focusing on assessment and having a thorough understanding of the HHRG, clinicians can correctly expose undiscovered acuities that will lead to greater payment.

If you don’t fully understand the elements of the HHRG or if you don’t apply it properly, you risk receiving less payment than you deserve. Sign up today for "Making the Most of the HHRG" and learn how to fill the gaps between theory and practice. The insights and tips you glean from each session will pay huge dividends through higher Medicare payment.

The original HHRG case-mix model featured 23 OASIS data elements, including three groups of case-mix diagnoses. The revised HHRG Four-equation Model has 52 elements, with 20 diagnosis groups. Add in Nonroutine Supplies Model - "The Supply HHRG" - and it is easy to see why so many clinicians struggle with its application.

IN THIS FOUR-PART SERIES, we’ll explore each of the 52 elements of the HHRG Four-equation Model and the 49 elements of the "Supply HHRG." Clear examples, case studies, and answers to frequently asked questions will enhance your understanding. You’ll learn:

• When each element comes into play and proper application
• Combinations, interactions, and responses along with their impact on payment

Session 1: Analysis of the Case-mix Structure: An Overview
(Recording available)

• Recognize the changes in the case-mix structure
• Learn the purpose of the HHRG and understand the goals
• Analyze the HHRG Four-equation Model:
--- An overview of equations, grouping steps, and line items
--- How it works in determining payment
--- Definitions and roles of the HHRG and HIPPS Code
--- A case study - from assessment to payment
• Become familiar with the nonroutine supplies case-model (a.k.a. the "Supply HHRG")
• Payment and care delivery implications

Session 2: Analysis of Updated Case-mix Components
(Recording available)

• Explore orthopedic, diabetic, and neurologic case-mix diagnoses (elements in the original PPS HHRG case-mix model in 2000)
• Take a closer look at the updated clinical and function dimensions
--- What’s still there, what’s changed
--- Payment and care delivery implications
• What’s included and what’s not
• Documentation strategies to support the patient’s case-mix

You’ll discover how the HHRG works and its impact on agency payment and compliance. These important insights and practical approaches will help you:

• Fine-tune OASIS assessments
• Clarify OASIS responses and diagnosis coding issues
• Document appropriately to support the case-mix
• Receive all the payment you’re allowed, within the law
• Manage the risks inherent in the HHRG for each patient
• Clear away common confusion and misunderstandings

Session 3: Analysis of New Case-mix Components
(Recording available)

• Study the new case-mix diagnosis groups
--- Insights into points assigned
--- Impact of comorbidities, combinations
• Make sense of the services utilization dimension
--- Problems with interpreting S scores
--- The role of M0826, therapy need
• Payment and care delivery implications

Session 4: Analysis of Wound and Skin Diagnoses and Data Elements
Thursday, August 21, 2008; 1:00 - 2:00 P.M. Central Daylight Time

• Understand "Skin 1 and 2" groups, skin conditions
--- Pressure, stasis, diabetic, and other ulcers; surgical wounds
--- Role in the supplies case-mix model
• Examine strategies for OASIS data elements on wounds and ulcers
• Payment and care delivery implications

Earn 1.0 contact hours for each nurse participant per session by returning a completed evaluation with a $5.00 per person processing fee - (CLICK HERE) for additional information.

The Presenter: Diane J. Omdahl, RN, MS