a group of clinicians high fiving

Where is your agency “Winning?”

Unbelievably, the 1st Q of 2022 is already behind us. While the pandemic is not yet fully behind us, we are moving very quickly toward a return to “normal.”  I place “normal” into quotations because the majority of us have determined that the PHE (Public Health Emergency) has made the term “normal” look vastly different.

During the PHE, what changed about your agency? Have you taken a moment to evaluate this?

It is time to start the evaluation of where your agency was in February 2020 vs. today. In February 2020, we were only 2 months into a new payment program (PDGM). We were discussing how much we disliked the “behavioral adjustment” language that was in PDGM. Also, many agencies had made the decision to ration therapy services. Not sure why this happened, but it seemed many in our industry had determined that since we no longer received “extra” monies based a number on therapy visits, that therapy was somehow, no longer valuable. This perception, while easy math, is much more nuanced. When the PDGM system was formulated, it included renumeration for cases that required therapy. The implications of agencies deciding to limit access to therapy are unknown, but as MAC reviews increase, we can see there is a special focus on this issue.

Does anyone think we know the full impact of our early PDGM decisions? I for one, do not think we have. I know that when your practice patterns change as a direct result of new legislation it usually does not end well.

Many of you remember very clearly the ADR’s and review processes, from MACs, which were born out of the perceived and real “gaming” of therapy visit numbers. The Targeted Probe and Educate (TPE) process was generated and created due to this practice.

As you begin to evaluate where you are today, compared to February 2020 make sure to take the time to decide where you want yourself and your agency to be in the future. We do not know what challenges lay ahead but we do know what is happening now. We have staffing challenges that are unprecedented, and our home health patients are not getting any easier, or less complicated.


Take time every day to visualize and plan for the agency you want. Learn from the areas where you have excelled and learn even more from the aspects of your agency that have failed. Keep the “winning” aspects and consider re-tooling or eliminating the failures. Without an objective eye this can be an arduous task. If you seek outside help, make sure they can help you get to your goals, not assimilate you into their goals.


The time is now to set goals and expectations for your agency. We can help!! Get started by contacting us today!