LUPA & PDGM

    LUPA Prevention Strategy

    Structured approach for identifying patients at risk of a Low Utilization Payment Adjustment.

    Definition

    A LUPA Prevention Strategy is a structured approach for identifying patients at risk of a Low Utilization Payment Adjustment and improving care planning, scheduling, and documentation to reduce avoidable LUPAs.

    Why it matters

    Effective strategies focus on clinical appropriateness, timely communication, and operational visibility. Visit frequency should always be determined by patient needs and the physician-approved plan of care-not reimbursement goals.

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    Conversations on lupa & pdgm

    Episodes from Inside Home Health that put LUPA Prevention Strategy in operational context.

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