If you're setting up an intermittent visits - home health care company as opposed to providing private duty shift care in the home....
Reimbursement under medicare (PPS) basically is now based on an episode payment.
In a quick nut shell... (and it's way more complex than this!!!) Doctor gives you a referral....
Nurse makes 1st visit and fills out the OASIS (PPS document with MANY questions). Based on the answers to these questions which include the primary skilled care diagnosis for the home care visits, and many answers about the patient's abilities to care for himself, you will receive a specific rate for reimbursement for a 60 day episode of care. (The answers are numerically weighted and add up to a HHRG which equates to a dollar amount for your geographic location.)
This reimbursement comes in 2 lump sum payments, and covers ALL (visits) care you provide for that patient (Nurse, Aide, MSW, PT, OT,ST) for the 60 day period. In several instances, it also
covers any supplies such as dressings, ostomy supplies, etc. that you provide for the patient.
Medicare no longer pays per each visit made. (Yes, there is an exception...if you make less than 5 visits they will pay for each visit.)
But say you have a patient who needs to be seen daily....they can lose money for you....but the catch 22 is you have to accept some of them or risk being banned from accepting medicare payments.
Each case will be different. Some patients can conceiveably make you a profit, and others will possibly eat up the profits.
Home health is a rewarding industry, but you won't get rich in $$$$.
For more information see:
Hope this helps.