How Medicare Reimbursement Is Impacted by OASIS & Outcome Programs

Date: January 22, 2026

Location: Webinar

Registration: Online

DESCRIPTION

Numerous factors contribute to the calculation of Medicare reimbursement under the Patient Driven Groupings Model (PDGM), as well as various other programs that can also impact reimbursement.  Home Health Value-Based Purchasing (HHVBP), Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS), and the Home Health Quality Reporting Program (HHQRP) program can all have a reimbursement impact for Medicare claims.  This session will review the details of these programs and how they directly impact reimbursement for home health agencies.

OBJECTIVES

• Identify all elements that are used to calculate the PDGM HIPPS codes for payment.
• Detail the elements that are used in the HHVBP Total Performance Score (TPS) and how the Linear Exchange Function (LEF) is used to calculate the impact on future Medicare payments.
• Review the measures in the HHCAHPS model that impact the HHCAHPS Star Ratings and impact the calculation of HHVBP and therefore impact payment.
• Outline the requirements of the HHQRP and how noncompliance will create a 2% decrease in future payments.

FACULTY

Melinda A. Gaboury, with more than 33 years in home care, has over 23 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving as Chair of the The Alliance/HHFMA Advisory Board and Work Group and is serving on the board of the Home Care Association of Florida and the Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E1 and Home Health Billing Answers, 2025.

PRICING

To obtain member pricing, please log in to your profile before registering. 

OAHC Member: $79 per person
Non-Member: $158 per person

CONTINUING EDUCATION CREDITS

This program has been designed to meet the continuing education requirements for the Minnesota Board of Nursing for 1.5 contact hours. It is the responsibility of the participant to ensure that this program meets the licensing and continuing education requirements of their state board and to retain the required documents in their personal file. Attendees must participate in the entire presentation for contact hours to be awarded – partial credit will not be available.  To apply for nursing contact hours, within one week following webinar participation, a completed sign-in sheet and evaluations from each individual must be returned to MHCA.  Certificates will then be issued by e-mail.

CONFIRMATION

The cost of this education is per person.

Prior to the webinar, a Zoom Webinar link will be e-mailed to you. You will need to click on this link to access the webinar, a dial-in number and an access code to listen in via telephone will also be provided. You will also be sent any pertinent handouts if available and evaluation link to the email address you provide.

WEBINAR RECORDING

This webinar will be recorded and available for 30 days following the webinar.

QUESTIONS?

Please contact Brandy Sweet at [email protected] with questions.

Oregon Association for Home Care PO Box 7245 Salem, OR 97303