Mastering PDGM: Financial, Quality & Strategic Management - Sacramento

PROGRAM OVERVIEW

This comprehensive day of The Patient Driven Groupings Model (PDGM) is going to give agencies the biggest and best chance to fully understand the current model and coming changes.  This will assist in confirming the need for additional changes within your agencies.  This workshop provides a quick overview of the PDGM structure and operations along with a review of the concerns and opportunities triggered by PDGM. The Financial portion of the workshop will assist agencies in monitoring their impact and analyzing what will be necessary to adjust with coming updates in 2026.  Strategic Management will include operational decisions regarding the Revenue Cycle, Clinical Operations and Quality reporting.  The Home Health Value-Based Purchasing Model which has taken our agencies by storm will be detail reviewed in analyzing the first two years of results and where we are headed with 2026 changes.

Program Topics:

9:00 – 10:30 Session 1 – PDGM Structure

• Outline the structure of PDGM

• • Review the pieces of the HIPPS Code
  • Review the reimbursement changes specific to coding
  • Review the impact of billing errors

10:30 – 10:45 Break

10:45 – 12:00 Session 2 – Home Health Quality Reporting Program

• Detail criteria for HHQRP

1. • • Review the requirements of the OASIS/HHCAHPS Participation Compliance
     • Review Details of the 2026 NEW HHCAHPS Survey effective April 1, 2026
     • Review NEW HHQRP Star Ratings – the result of survey & OASIS changes.

12:00 – 1:00   LUNCH

1:00 – 2:30 Session 3 – Home Health Medical Review

• Detail Specific Medicare Medical Review Issues affecting Home Health

1. • Review 2026 HH Face-to-Face Requirements
   • Detail key billing codes that trigger Medical Review
   • Audit Risks – CMS Targeted Probe & Educate, SMRC, UPIC & RAC
   • Top 5 Denials and Avoiding those denials

2:30 – 2:45 Break

2:45 – 4:00 Session 4 – Home Health Value Based Purchasing Model

• Detail the HHVBP Model & Most Recent Results
  1. • Review details of the measures in the HHVBP Model for 2026
     • Detail review the Interim Reports
     • Review Best Practices for Improving Scores

FACULTY

Melinda Gaboury, COS-C
Chief Executive Officer
Healthcare Provider Solutions, Inc.

Melinda A. Gaboury brings 33+ years in home care, including 23+ years as an executive educator and national speaker for home care and hospice professionals. She leads reimbursement workshops nationwide and specializes in Medicare PDGM, billing and collections, case-mix, chart reviews, and due diligence, with current focus on UPIC/RA/ADR/TPE audits and appeals across Medicare MACs. Melinda serves as Chair of The Alliance/HHFMA Advisory Board & Work Group, sits on the boards of the Home Care Association of Florida and the Tennessee Association for Home Care, and is the author of Home Health OASIS Guide to OASIS-E1 and Home Health Billing Answers (2025). 

CANCELLATIONS

Cancellations are subject to 30% handling fee. There will be NO REFUNDS issued for cancellations received within 10 business days prior to program. Cancellations must be in writing. Refunds will not be made for no-shows. However, substitutions will be allowed. Should CAHSAH® cancel the program, a full registration fee refund will be issued.

CONTINUING EDUCATION UNITS (CEUs)

Provider approved by the California Board of Registered Nursing (Provider #CEP17394) for six (6) contact hours of continuing education. Continuing Education report will be issued to attendees once attendance has been confirmed.