Political strategist James Carville famously quipped during the 1992 U.S. presidential campaign, "It's the economy, stupid." Name-calling aside, for physical therapy in post-acute care settings, it's the application of recently revised payment systems and a proposed unified payment model within these settings that is key to ensuring that patients get the intensity of services they need.

In 2020 the Centers for Medicare & Medicaid Services adopted the Patient-Driven Groupings Model for home health agencies, shifting from volume-driven payment to a model focusing on the unique characteristics, needs, and goals of each patient. The idea is to place HHA periods of care into more meaningful payment categories, while eliminating the use of therapy service thresholds for adjusting payments for home health episodes.