PDGM Consulting for Home Health Agencies
The Patient-Driven Groupings Model (PDGM) has transformed how home health agencies are reimbursed, placing a stronger emphasis on clinical complexity, accurate documentation, and timely patient outcomes. If your agency is struggling to stay current with PDGM guidelines—or if you simply want to maximize your reimbursement potential—our PDGM Consulting services provide the expertise you need without unnecessary hype.
The Gravity Game Plan
A Clear Path to Better Results
OASIS & Coding Accuracy
We review your OASIS assessments and ICD-10 coding processes to ensure every patient’s condition is documented accurately and completely, which directly impacts HHRG scoring.
→ Because if your documentation doesn’t fully capture patient complexity, your reimbursement—and your quality scores—will always fall short.
Workflow & Process Improvements
Our team pinpoints inefficiencies in your referral intake, care planning, and discharge processes. We then recommend realistic changes that help you capture rightful reimbursement while minimizing administrative burden.
→ Because better processes don’t just speed things up — they protect your margins and your staff.
Staff Training & Education
Your clinical and administrative teams receive practical, easy-to-follow guidance on PDGM best practices. This includes proper use of assessment tools, documentation tips, and ongoing compliance updates.
→ Because the right training closes gaps, reduces errors, and strengthens every claim you submit.
Performance Tracking & Adjustments
We monitor your key metrics—such as case-mix weights, episode spending, and claims acceptance—to identify areas where you can further refine care delivery and secure sustainable margins.
→ Because monitoring performance isn’t about data for data’s sake — it’s about making smarter decisions, faster.
Common Challenges We Address
Underreported Diagnoses resulting in lower-than-expected reimbursement
Inconsistent Documentation leading to claim denials or lost reimbursement
Lack of Clear Procedures causing staff confusion and workflow disruptions
Minimal Ongoing Monitoring leaving agencies unaware of revenue leaks or compliance risks
Why This Work Pays Off
Staying compliant with PDGM is no longer optional—it’s essential for maintaining consistent revenue streams and delivering top-quality care.
By focusing on accurate coding, thorough documentation, and streamlined workflows, you not only improve your reimbursement but also enhance patient outcomes and staff satisfaction.
Ready to Strengthen Your PDGM Performance?
When you’re ready to ensure your agency is capturing every dollar it deserves under PDGM, we’re here to help. Reach out to discuss your current challenges and learn how our consulting services can be tailored to your unique needs.