The Patient-Driven Groupings Model (PDGM) is a payment model for what services?

• A. Payment model for home health services.
• B. Data from Medicare FFS Claims Data for quality measures.
• C. Survey assessing patient experiences in home health.
• D. Specific criteria for excluding cases from measures.

Answer: (A)

PDGM is the Medicare payment model used to reimburse home health agencies for 30-day episodes of care. It determines the payment amount by placing each episode into a payment group based on patient characteristics and timing of admission, rather than paying for the number of therapy visits or services provided. This shifts reimbursement to reflect the patient’s condition and needs, making the approach more patient-centered and episode-focused. The other options describe data uses or assessments (quality measures, patient experience surveys, or exclusion criteria) rather than how payments are determined under PDGM.