Impact Act Solutions for Value Reforms

Over 30 Years of Post-Acute Leadership

Home Health Strategic Management (HHSM) is a progressive healthcare practice delivering Post-Acute Utilization Review (UR) programming to Health Systems and Post-Acute Providers responding to CMS Impact Act reforms. Arnie Cisneros PT, President and Founder, has a history of 30+ years of clinical rehab delivery and management across the care continuum, and his legacy as a rehab Provider and clinician across the evolving PPS Post-Acute continuum offers insight into Value era changes required for success. HHSM’s PAC UR Care Protocol has outperformed traditional Post-Acute management models under PPS, PDGM and other Impact Act reform Alternative Payment Models. Under PAC PPS, HHSM’s PAC UR model provides Hospitals & Health Systems with seamless episodic management as patients progress from acute to Post-Acute programming.

Progressive Post-Acute Care Management

By adapting Utilization Review (UR) techniques employed for managing acute inpatient programs, HHSM developed a Post-Acute UR Management Model called S.U.R.C.H. – Service Utilization Review for Care after Hospital. SURCH operationalizes the Medicare Benefit Policy Manual Post-Acute directive to produce CMS-compliant programs, and Providers post unseen clinical and fiscal outcomes. SURCH has been validated by CMS on numerous occasions:

SURCH was named the 2017 VNAA Innovative Care Model award for CMS Impact Act reform outcomes.

SURCH is accepted by CMS as a Plan of Correction for Home Health Providers on Focus Audit Review, assuring compliant HH Care management.

SURCH was the operating Model for the Detroit Medical Center’s BPCI Total Joint Replacement CJR Pilot program. The DMC, a Pioneer ACO System, posted the highest savings and lowest readmissions of any BPCI CJR Pilot based on SURCH’s real-time PAC Clinical Acuity model.

SURCH has performed PAC PPS trials with Pioneer ACO populations to outstanding results, savings, and single-digit readmissions.

SURCH is the clinically based management system that exceeds AI outcomes in both clinical and fiscal terms under PDGM, PDPM, and

UR Management of PAC Production and Delivery

Servicing Post-Acute clients across the Care Continuum during the installation of PPS, HHSM’s President Arnie Cisneros focused on value-based care production and delivery rather than the fee-for-service payment model. By employing insight into subsequent CMS Care sites, he was able to swiftly move patients through acute episodes by matching changing acuity to Post-Acute Providers. Through this approach, acute care Providers provided patients seeking a rapid return to home, foretelling the Value era approach. HHSM has retained focus on efficient, best-practice care delivery modified in real-time for acuity changes. By embracing CMS models (and reforms) and assuring skill management with an eye on rapid functional changes for an optimal return to PLOF, HHSM have remained leaders in progressive adaptation of PAC alternative models.


HHSM has developed an exciting homecare program that utilizes real-time solutions to solve clinical questions and decisions Medicare-certified agencies face daily.

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As leaders in the industry, HHSM often presents at conferences, sharing knowledge we’ve learned from over 30 years of experience.

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Home event

  • Home Care & Hospice Association of NJ – Webinar Series  2024
  • Home Care & Hospice Association of NJ – Webinar Series 2024
  • The Path forward for HH under New Value-Based Care models
    Presenter – Arnie Cisneros

  • March 26, 2024
  • Hosted by Home Care & Hospice Association of NJ

  • View all presentations ›
  • "Very knowledgeable. Engaged the audience"
    2018 MAHC Annual Conference
    "Speaker was very engaging & knowledgeable in above topic. Kept me interested from start to finish."
    2018 MAHC Annual Conference
    "Arnie's presentation was excellent! All info was pertinent and informative"
    2018 HCAF District Meeting - Ft. Lauderdale
    "Arnie always has a good global perspective."
    LMHPCO/HCLA 2019
    "Arnie's presentation was amazing. Very informative, very inspirational"
    2018 HCAF District Meeting - Miami
    "Excellent! Best presentation so far. Speaker was knowledgeable with valuable information."
    2016 HCAF Annual Conference, Orlando FL
    "The best class yet!"
    2018 HCAF District Meeting - Orlando
    "Excellent presentation; great info on proposed upcoming challenges"
    2018 HCAF District Meeting - Ft. Myers
    "Great presentation by Arnie! Thought provoking; the information was awesome, really got creative juices flowing"
    2018 HCAF District Meeting - Ft. Myers
    "Kim kept it lively, funny, and relevant"
    2018 HCAF Annual Conference
    "Known Speaker who's knowledgeable in home care."
    Michigan HomeCare & Hospice Association 2019
    "The information is always timely, accurate, and beneficial to agency operations"
    2017 VAHC Annual Conference
    "Needed to know this information – glad I came."
    Michigan HomeCare & Hospice Association 2019
    "Always appreciate Arnie & Kim's knowledge of the industry, new issues facing agencies & innovative approach to HH"
    2018 HCLA Annual Conference
    "Have her back!"
    2018 MAHC Annual Conference
    "Love Arnie's energy and passion for helping agencies be prepared for the future."
    LMHPCO/HCLA 2019