In the News

APTA, AOTA, ASHA: New Home Health Payment System No Reason to Compromise Care

As a new Medicare Part A payment model for home health agencies (HHAs) gets set to launch January 1, APTA and two other provider organizations are urging HHAs to keep patient access to needed care front-and-center, and not react to the new system with "unnecessary staffing changes."

In a joint statement by APTA, the American Occupational Therapy Association (AOTA), and the American Speech-Language-Hearing Association (ASHA), the organizations state:

"APTA, AOTA, and ASHA are aware of the potential for clinicians and assistants to be negatively impacted by the reactions of some home health agencies when implementing Medicare’s Patient-Driven Groupings Model (PDGM) on January 1, 2020. Unnecessary staffing changes could affect the clinicians’ practice patterns and their ability to exercise clinical judgment, as well as patients’ access to care — ultimately damaging the quality of therapy provided by home health agencies. Our organizations continue ongoing dialogue with CMS and home health agencies to ensure that Medicare beneficiaries continue receiving the skilled therapy they need. APTA, AOTA, and ASHA are committed to advocating on behalf of our professions and the people they treat."

The statement summarizes one of the central points APTA, AOTA, and ASHA have been driving home since PDGM was finalized for implementation on January 1, 2020: that PDGM changes nothing in terms of CMS' requirements that HHAs provide high-quality reasonable and necessary rehabilitation services and that clinicians use clinical judgment in determining appropriate frequency, duration, and modality of services.

As the new system is implemented, the association will be gathering on-the-ground information from physical therapists and physical therapist assistants on how HHAs are responding, and will share those reports with CMS. CMS will also be tracking utilization and patient outcomes under PDGM to ensure appropriate provision of therapy. If you have experiences to share related to implementation of PDGM (or the SNF PDPM), reach out to [email protected].

Learn the basics of how you can manage the PDGM in this "Compliance Matters" column published in PT in Motion magazine. Need more information? APTA has created an entire PDGM webpage with multiple resources to help you understand and make the case for your value in the system.


APTA's Latest 'Quarterly Report' Available Electronically Now

Posted: Dec. 17, 2019

The latest print issue -- Vol. 54 No. 4 -- of the APTA Home Health Quarterly Report is on its way to section members, but members can read it now on the section's new Quarterly Report Library page and selecting either the E-Reader or Download option (you must be signed in as a member). Not a member? Join us!

If you use the E-Reader, try using the handy new electronic table of contents. Just click the third button from the left on the control panel, and the table of contents appears. 




Posted: December 18, 2019

As part of overall efforts to move Medicare payment away from fee for service and toward a structure that holds providers accountable for patient outcomes and costs, the Centers for Medicare and Medicaid Services (CMS) has made significant changes to the skilled nursing facility (SNF) and home health payment systems. The SNF Patient-Driven Payment Model (PDPM) began October 1, and the Home Health Patient-Driven Groupings Model (PDGM) begins January 1, 2020.

Both PDPM and PDGM align payment with patient characteristics, conditions, and needs, and eliminate the connection between reimbursement and the volume of therapy services provided—time spent and number of visits. This change makes it ever more important to show the value and cost-effectiveness of physical therapist services within SNFs and home health care. At the same time, what doesn't change is the coverage criteria or documentation requirements associated with the skilled therapy service coverage under PDPM and PDGM. More important, there is no change to the care needs of patients, which should be the primary driver of care decisions, including the type, duration, and intensity of skilled therapies.

APTA has been working to keep the profession up-to-date with the evolution of the PDPM and PDGM through our news and social media outlets, webinars, phone-in sessions, and other free, open access resources on the APTA SNF and Home Health Payment Models website.

Three of the APTA Sections - Home Health Section, Academy of Geriatric Physical Therapy, and HPA the Catalyst, have a number of other resources on their respective websites to help clinicians prepare and thrive in these new payment models.

APTA also has been actively communicating with the press to highlight concerns surrounding the industry’s implementation of PDPM and potential inappropriate behaviors. Recent articles include:

The new payment models do not change the value of physical therapy services or patient needs. PDPM and PDGM expect rehabilitation professionals will continue to furnish high-quality therapy services that are reasonable and necessary. APTA maintains an ongoing dialogue with CMS and we are sharing with them the feedback we’re receiving from physical therapists and physical therapist assistants regarding their experiences with PDPM and PDGM. APTA will continue to carefully monitor implementation of the models and advocate for appropriate changes as CMS evaluates the systems during the first year of implementation.

Questions? Comments? Concerns? All physical therapists and physical therapist assistants (members and non-members) are encouraged to share their PDPM and PDGM experiences at [email protected]. Also, if you’d like to join the Post-Acute Care online community (Hub), please contact Kara Gainer at [email protected].



CMS has a new case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. APTA HHS Members, click the link below to login and check out the information on how this new model compares with the Home Health Prospective Payment System (HH PPS).

Click Here to Login and View Document!



2020 Home Health Section Awards

The Home Health Section Awards are presented to recipients at the APTA Home Health business meeting at APTA's annual Combined Sections Meeting in February.

The HHS is still accepting nominations for the following awards through January 1, 2020:

  • Emerging Leader in the APTA Home Health Section: Recognizes and honors one Physical Therapist or Physical Therapist Assistant who has demonstrated extraordinary service and clinical passion early in his or her home health career. The individual should have made exceptional overall accomplishments and contributions to the APTA and/or the Home Health Section mission and vision, and to the physical therapy profession to advance quality and evidenced‐based care in the home.

  • Excellence in Home Health Clinical Practice Award: Recognizes a physical therapist or physical therapist assistant for outstanding clinical practice in a home health care setting.

  • Excellence in Home Health Leadership Award: Recognizes the exceptional contribution of an APTA Home Health member in promoting home health physical therapy practice.

  • Friends of the Home Health Section Award: Acknowledges an individual, group or organization that has made an enduring contribution to the home health industry and that has been an advocate of the profession of physical therapy in the home, as is relates to clinical practice and/or regulations.

  • Preceptor Award: Acknowledges an individual that has been chosen by their agency/company to be a preceptor. This therapist demonstrates the unique qualities, high standards and clinical skills that are exemplary. They are organized and able to teach processes and procedures to newly hired staff, molding them into confident and talented home care clinicians.

  • President’s Award: Recognizes a Home Health Section member who has provided notable service to the Section.

To learn more about each award and to submit your nominations, click here

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