Per session: Members $49, Non-members $99   
Series package: Members $119, Non-members $219

Join all 3 and save on the 3-Part series. Sessions will be recorded -- no need to worry about missing out -- series registration will be available up to the final session.

Part 3: What Does This Mean for RCM and Agencies?

Bottom Line for RCM Leadership: The CY 2026 proposed home health rule signals a convergence of financial pressure, operational complexity, and quality realignment. RCM teams must quickly model impacts, optimize coding and documentation systems, recalibrate quality and value-based strategies, and advocate wisely as CMS finalizes the rule later this year.

• Tighten coding/OASIS accuracy to optimize case-mix appropriateness.
• Leverage tech to streamline documentation and support efficiencies.

Steps to Manage HH Margins through Clinical Quality: 

• Audit PDGM Coding and Visit Plans - Ensure diagnosis coding and comorbidity capture are detailed and accurate to protect revenue. Review visit plans carefully to avoid unintentional LUPA penalties due to new thresholds.
• Update Face-to-Face and Order Workflows - Adjust documentation templates for the expanded list of practitioners now allowed for F2F visits. Track any F2F issues as a key metric for avoiding denials.
• Protect Quality Reporting Data - Treat QRP submission deadlines like payroll, don’t miss them. Prepare early for digital reporting transitions (dQM and FHIR) by testing your data systems.
• Train Staff on New HHVBP Measures - Educate clinicians on new cost-based indicators, and OASIS functional items related to bathing and dressing. Improve processes to manage spending efficiency to improve Medicare Spending Per Beneficiary – Post-Acute Care (MSPB-PAC)
• Strengthen Denial and Audit Defenses - Be ready for more reviews from Medicare auditors focusing on behavioral payment adjustments. Keep documentation strong and organized to support every claim.
• Manage Labor and Visit Scheduling Closely - Align visit schedules with the new case-mix recalibration and LUPA thresholds. Use alerts to avoid plans drifting into under-visit situations
• Additional operational adjustments

Meet the Speakers

Arnie Cisneros is the President of Home Health Strategic Management (HHSM). He has over 30 years of experience as a physical therapist across the care continuum, and he serves as a Post-Acute Consultant for multiple Pioneer Accountable Care Organizations (ACOs). He is renowned for his adaptation of traditional health care operations to address ongoing Centers for Medicare & Medicaid Services (CMS) reforms.