Home Health & Hospice

What are regulators looking for in HHRG data?

Homecare Insider, June 27, 2016

The CMS and medical reviewers pay close attention to patterns in care delivery and Home Health Resource Group (HHRG) data. They are looking for trends indicating that payment is driving care delivery. Surveyors and intermediaries will focus on the accuracy and consistency of the information and how it is used.

The 2008 revisions to the case-mix structure made it very difficult for any individual to memorize the case-mix items and scoring, which is probably a good thing. That may mean less manipulation of assessments and diagnoses to increase points.