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PDGM Dashboard

The PDGM Dashboard provides insights at the patient level.

PDGM Case-Mix Analysis ($)

The PDGM Case-Mix Analysis feature compares the agency’s revenue for a single patient under PPS to the projected revenue under PDGM. Once an OASIS is complete, users can view the PDGM Case-Mix Analysis by clicking the green dollar sign symbol next to the completed OASIS assessment in the Schedule Center.



Permission to view this feature is given in the Permissions tab when adding or editing a user. To give a user this permission, select the Admin tab ➜ Lists ➜ Users. In the Users list, find the appropriate user and select Edit. Select the Permissions tab on the left-side menu. Scroll to the Billing section on the right side of the Permissions screen, and select View HHRG Calculations. Click Save. The user will then be able to view the PDGM Case-Mix Analysis in the Schedule Center.



The analysis will enable you to see HHRG scores under PPS and PDGM and prepare for accurate coding, LUPA thresholds for each 30-day payment period, and proper visit utilization under PDGM.



Click the video below to watch an overview of the PDGM Case-Mix Analysis feature:


Gross Margin Calculator

The Gross Margin Calculator shows your agency’s gross profit and loss so you can adhere to predetermined gross margin percentages and evaluate care and utilization more closely. It assists with financial operations by ensuring the proper steps are taken upfront to encourage accountability and communication between financial and clinical operations.



All users with access to the Quality Assurance (QA) Center can open the Gross Margin Calculator when reviewing OASIS documentation.


The following items are available in the in the Gross Margin Calculator and explained further below:


OASIS Episode Information

Average Discipline Cost Per Visit X Number of Visits = Total Cost

(Average discipline cost per visit is identified in Manage Company Information under the Admin tab.)

1) Use the Cost Modeling tool to adjust the number of therapy visits, then update Therapy Visits (M2200) in the OASIS assessment.

2) Update the Clinical and Functional items in the OASIS assessment.

Once the OASIS assessment is updated, the information in the Gross Margin Calculator will automatically update to reflect the changes.


Cost Modeling

Frequency X Average Cost Per Discipline + Supplies = Total Cost

The average cost per discipline is pulled from Manage Company Information and should be based on numbers from the agency’s cost report, which includes visit cost plus overhead.


Payment Projection

Case-Mix Rate – Total Cost = Expected Payment



OASIS Case-Mix Analysis


Clinical Points:


Functional Points: 


Non-Routine Supplies (NRS) Points: 



The table below demonstrates the total points for the corresponding therapy visits and episode that produce the Home Health Resource Group (HHRG):