Take an inside look at how the home care industry fared during the early stages of PDGM with an in-depth analysis presented by BlackTree Managing Principal Nick Seabrook and SHP Vice President of Product Strategy Chris Attaya. Using SHP’s robust, real-time provider data, we’ll examine clinical, operational and financial indicators and measure the impact of COVID-19 on PDGM performance. We’ll also discuss how agencies should be completing their own internal analysis of actual agency performance under PDGM compared to projections.

Trending the Data

Functional Impairment Level

  • 8% scored High for 2020 YTD – CMS projected 31.5%
  • Bathing and Ambulation comprise more than half of the functional impairment points


  • LUPA rates peaked in March at 11.9%
  • LUPA thresholds of 5 & 6 make up 16.9% of HIPPS codes, but make up 28.4% of all LUPAs

Visit Utilization

  • Therapy visits per period decreased from 5.32 to 3.64 from January to April
    • Nursing took less of a hit with a decrease from 5.02 to 4.

Key Takeaways

Cash Flow Impact of PDGM & COVID-19

“The impact of COVID was – in March we never saw that spike back above those (December) numbers.”

– Nick Seabrook, BlackTree Managing Principal

Case Mix Weights

  • Average case-mix weight for period 1: 1.345
  • Average case-mix weight for periods 2-5+: range from 0.855 – 0.881


“I think the reflection here is, when you’re thinking about budgeting, Early and Late…are one of the more important factors you’re going to want to consider.” – Chris Attaya, Panelist

BlackTree Recommends

  • Look at the benchmarks presented in this webinar and measure your agency against these numbers
  • Don’t just look at the high level – take a deeper dive into what is impacting your KPIs under PDGM
  • With cash flow challenges, assess your Billing KPIs: percentage to collections, unbilled, outstanding AR, etc.