Serving the home health, home care and hospice industry since 1999.

Axxess announced on July 23 that it has introduced several valuable tools within its software solution to help clients prepare for the Patient-Driven Groupings Model, which goes into effect in January. The company believes this release makes it the first software partner to deliver a full suite of tools to review and prepare for the impact of PDGM.

Among several important features Axxess clients can use are tools that use their own data over the past three years to analyze the revenue impact PDGM will have on the agency for specific episodes of care, and how the agency’s current case-mix will be impacted under the new payment model. Axxess also has provided a PDGM modeling tool that enables agencies to model key PDGM components during the intake process to assess what impact the new referral would have on reimbursements.

"PDGM is the biggest regulatory change for our industry in more than 20 years, so the features we provide to help our clients prepare for the changes under the new payment model are extremely important," said Andrew Olowu, Chief Technology Officer at Axxess. "Our in-house engineering team is proud to have developed and delivered these valuable tools to help our clients thrive under PDGM."

Features Axxess has shared with its clients to help them prepare for PDGM include:

  • PDGM Revenue Impact Analysis: This feature uses historical OASIS/visit information to assess the impact of PDGM on revenue, based on past episodes. This feature helps administrators or operators adjust agency behavior ahead of PDGM implementation next year.

  • PDGM Case-Mix Analysis: Once the OASIS assessment is completed, the OASIS profile provides a comparison of the case-mix reimbursement impact under the current PPS model versus what is projected under PDGM. This feature also allows agencies to monitor Low Utilization Payment Adjustment (LUPA) thresholds.

  • PDGM Modeling Tool: During the patient admission process, intake coordinators can learn and model the key components of PDGM to understand the impact of the new referral on reimbursement. This feature shows the case-mix groupings under PDGM and displays the financial implications of the different options selected.

  • Intake Form Updates: During intake, Axxess’ software highlights questionable encounter codes (QECs) to help train and correct documentation behavior in advance of PDGM. This will help ensure agencies get paid for the care they provide.

  • No-Pay RAPs: This feature helps agencies that have been certified after January 1, 2019, or who are on RAP suppression to more accurately forecast their revenue and improve revenue cycle management.

  • New Billing Center: The new billing center streamlines the billing process by removing extra steps and making access to claims history easier. From this center, 30-day RAPs and Final claims can be created. These changes make the adjustment to PDGM much easier for Axxess clients. Olowu said Axxess in-house experts have been training the entire company over the past several weeks on how the tools work so they can provide needed support to clients in helping them prepare for PDGM.

In addition to announcing that these PDGM features are available months ahead of the January, 2020 implementation of the new payment regulations, Axxess reports that it has also developed a PDGM resource center that provides on-demand videos, step-by-step guidance on the new PDGM solution features, FAQs about PDGM, and other resources. In addition, Axxess industry experts have shared valuable insights and thought leadership in a series of webinars and PDGM blog articles that are available through the company website.

"Our leadership in helping our clients get ready for PDGM is a continuation of the innovation leadership that drives our company every day," Olowu said. "We have every confidence Axxess clients will be the best prepared to thrive under the new PDGM payment model in the years ahead."


©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.