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Case Management and Clinical Pathways

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Date Published

July 16, 2020


Ohio Health Care Association


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This presentation will give a high level overview of the PDGM structure with a focus on appropriate diagnosis coding as well as the need for interdisciplinary collaboration for the comorbidity adjustment as well as the functional impairment levels. This collaboration in conjunction with the establishment of clinical pathways should allow for a decrease in the instances of Low Utilization Payments as well as to earlier identify high-risk patients and avoid unnecessary hospitalizations and ED visits. We will briefly cover Review Choice Demonstration as well as dive into how HealthPRO Heritage at Home has innovatively operationalized Care Pathways to Success.

Learning Objectives:

  1. Understand the financial impact of the Functional Impairment and Comorbidity PDGM components and how to implement good practices within your organization
  2. Understand the concept of a moving LUPA threshold and how IDT collaboration at the initiation of care can determine effective visit utilization
  3. Identify your high-risk patient population and how to maintain their care in the home
  4. Identify if your agency would benefit from Care Pathway implementation and where to begin
Credit Information - 1.0 CEs is available for this course from the following:

Ohio Administrators: The Ohio Health Care Association is an approved provider of continuing education credit by the Ohio Board of Executives of Long Term Care Services and Supports (BELTSS). Approval #36811-SS-20.

Ohio Nurses: Nurses please note any continuing education that has been approved by BELTSS (or any other accredited body) can be accepted by the Ohio Board of Nursing in the State of Ohio. Nurses may use this continuing education to meet their licensure requirements. Please refer to OBN continuing education rules 4723-14-01 through 4723-14-19.

Certified Executives for Home Care & Hospice (CEHCH): This program has been approved and can be used toward the renewal of the CEHCH certification.

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Jason Sasser, PTA, CWT, CSS, COQS
Vice President of Clinical Strategies

Jason is also Interim Chief Operating Officer for Stonerise At Home/Hospice. He is a certified OASIS Quality Specialist and... Read More

Stephanie Hansen, PTA, COQS
Regional Vice President - HealthPRO Heritage at Home

Stephanie has 15 years of experience across acute care, outpatient, long-term care and home health settings with a focus on... Read More

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Program Titles and Supporting Materials

This program contains the following components:

Video Presentation
Slide Deck Copy
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If applicable, you may obtain credit in multiple jurisdictions simultaneously for this program (see pending/approved list below). If electing credit for this program, registrants in jurisdictions not listed below will receive a Certificate of Completion that may or may not meet credit requirements in other jurisdictions. Where applicable, credit will be only awarded to a paid registrant completing all the requirements of the program as determined by the selected accreditation authority.

Click on jurisdiction for specific details:

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How to Attend

Join the self-paced program from your office, home, or hotel room using a computer and high speed internet connection. You may start and stop the program at your convenience, continue where you left off, and review supporting materials as often as you like. Please note: Internet Explorer is no longer a supported browser. We recommend using Google Chrome, Mozilla Firefox or Safari for best results.

Technical Requirements
You may access this course on a computer or mobile device with high speed internet (iPhones require iOS 10 or higher). Recommended browsers are Google Chrome or Mozilla Firefox.

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