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Bill Dombi on the Revised PPS System

Bill Dombi, Vice President for Law at NAHC, and Mary St. Pierre, Vice President for Regulatory Affairs, give us a great update on the new PPS revisions that are taking effect in January.

Bill said a couple of things that I think are significant:

“We’ve only begun to introduce you to confusion today.” These revisions have many confusing features, and it will take a while for us to understand the changes and their implications for our home health agencies.

And, he made it cleear:

“Don’t be worried. Be Attentive.
Pay attention. Get ready.
If you survived IPS, this will be a cake walk.”

Bills words confirmed for me what I had been observing all along. These changes are significant, but many people have been making much more of them that is needed. I remember being the Interim President and CEO of a $25 million home care company that lost $2.75 million in 1998. We were able to turn that ship and survive. Two years after the roll out of PPS, that agency was making more money that the hospital it is part of.

Bill did give us a “Weather Report” for the coming impact of the revised PPS based on CMS projections.

  • Voluntary non-profits (VNAs), facility based agencies, and government agencies will gain. Free standing for-profits will lose. The main reason is therapy thresholds.
  • Urban agencies ill gain slightly and rural agencies will lose.
  • Agencies in the north will gain and agencies in the South will lose. ( A friend from New Orleans leaned over to me and whispered, “We did lose the civil war, after all.”)
  • Agencies in New England and Mid-Atlantic will gain and agencies in the West South Central will lose.
  • Smaller agencies are at greater risk than larger agencies.

But remember, how accurate is the weatherman in your town?

Did you hear Bills message? What do you think about the impact of the PPS revisions? Give us your comments below.

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