PPS--how will it impact your agency and your practice?

PPS is being greeted with cautious optimism. The time for change from the cost reimbursed system is long overdue. PPS is intended to reimburse providers by patient need, a system that should provide incentives for quality, cost-effective care. To be fully ready for this change, agencies should prepare for closer tracking of patient care needs and costs, and plan for significant changes in accounting practices. Appropriate staffing patterns and reducing turnover will be important personnel issues. PPS will require nurses to evaluate and plan patient care completely, to make quality visits, to change care in a timely manner when necessary, and to be vigilant in discharge planning and identifying resources. Use of technology, specialty nurses, and closer supervision of care patterns to achieve desired outcomes with maximum efficiency will be important. Clean claims and DDE capability to adjust claims will help ease cash flow problems. Knowing what factors make you a target for medical review will help you to avoid claims delays. Our goal for nursing under PPS seems simple: get our clients well in a timely and cost-effective manner. Seventy-four million baby boomers will enter the Medicare system toward the end of the next decade. Demography, epidemiology, and economics make it clear that a healthy long-term care system is a must. The home health industry's role in that long-term care system will be determined by the home care industry's response to PPS.