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PDGM Center

The PDGM Center displays targeted insights into the Patient-Driven Groupings Model with real-time aggregate data. Using the information in the PDGM Center, organizations can analyze critical components of PDGM, develop data-driven business decisions, review the impact of patient care, and assess the impact of PDGM on revenue. To access the PDGM Center, hover over the PDGM tab in AgencyCore and select PDGM Center from the drop-down menu.

From the PDGM Center, users can navigate directly to the PDGM Billing Center, Revenue Impact Analysis, PDGM Modeling Tool, and PDGM Resources screens to access the following functionalities for PDGM preparation:

PDGM data will begin populating in the following PDGM Center feature tiles beginning January 1, 2020:

Tile Description
LUPA Risk Alert  Users receive LUPA risk alerts when scheduled visits fall outside a specified threshold. This tile displays the number of at-risk patients categorized by low LUPA risk, high LUPA risk, and LUPAs.
% of Agency LUPAs  Displays the agency’s percent of LUPAs in real time
Avg. Length of Stay  Displays the agency’s average length of stay in real time
Upcoming 30-Day Review  Users receive alerts as patients enter the last seven days of the first 30-day billing period. This tile enables users to review the focus of care and verify completion of all orders, visits and documentation to submit final claims in a timely manner.

Users can view components of the Home Health Resource Group (HHRG), including admission source and timing, functional score, and comorbidity adjustment data in the following respective tiles:

Admission Source and Timing    Displays the percentage of early vs. late and institutional vs. community patients
Functional Status Displays the percentage of patients at each functional status (high, medium, low) at Start of Care and Recertification     
Comorbidity Adjustment  Displays the percentage of comorbidity adjustments (high, low, none) at Start of Care and Recertification     

Average Revenue per Billing Period  Displays expected revenue for each billing period sorted by clinical grouping
Top 5 Primary Diagnoses Displays the agency’s five most commonly used diagnoses, and how many times the agency has used each of the top five diagnoses, in a bar graph for easy at-a-glance review     
Number of Patients per Clinical Grouping    Displays the number of patients in each clinical grouping in real time