Patient Driven Grouping Model

Change to REGULATORY REQUIREMENT for Payment

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Patient Driven Grouping Model (PDGM) was the largest change to the reimbursement model for homecare in decades. It meant major changes for how homecare agencies operate, both clinically and financially, and failure to adapt the new model was expected to cause many agencies to close.

 

THE CHALLENGE

PDGM caused major anxiety for our customers. We needed to understand those concerns, understand opportunity space, and plan educational content around the change. Some competitors would not be covering this change because it was so large.

The Outcome

By gathering an understanding of customer concerns, I was able to advise Marketing and Customer Care on topics that would help customers. They had high attendance webinars and education sessions. Project teams were able to build solutions in advance of the CMS effective date because of prioritization and well-planned designs. The sales team was able to demo the PDGM solutions and secure contracts above what was projected. Customers reported easy change-over to new requirements. Most continued to operate with similar or small increases in profit margins. Measuring customer success was difficult because the pandemic start coincided with the first billing period.

METHODOLOGIES USED IN THIS PROJECT

  • Design Thinking

  • Journey Maps

  • Ethnographic Research

  • User Interviews

  • Story Mapping

  • Expert Interviews

  • Usability Test

THE APPROACH

Using design thinking activities, we gathered 23 users to explore their concerns and pain points. The group worked together to prioritize their concerns and come up with solutions together.

 

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