Hospice SIA and Best Practices for Quality End of Life Care

CMS created the Service Intensity Add-on (SIA) in recognition of patients and families needing more intensive care and services during the last seven days of life, and that hospices must be reimbursed for these very important services. However, two years after the 2016 Hospice Payment Rule instituted the SIA, it is clear that many hospice organizations have not optimized it.

Catherine Dehlin, Fazzi’s Director of Hospice Services provides a more complete understanding of the benefit and best practice strategies to help ensure patients and families receive high quality end of life care. You’ll receive specific and actionable recommendations in these areas:

  • Direct care
  • Scheduling and staffing
  • Escalation of services
  • Care planning
  • Interdisciplinary team communication
  • QAPI

Continue reading “Hospice SIA and Best Practices for Quality End of Life Care”

Survey Reveals Agencies’ Current Thoughts on PDGM Impact

The change from 60 day to 30 day payment periods, the elimination of therapy thresholds and education of staff and management are agencies’ top concerns about PDGM, according to a recent survey conducted by SUNY Oswego.

You may recall that late last year, we co-sponsored a survey by SUNY Oswego to gauge agencies’ understanding of and perceptions about the Patient-Driven Groupings Model (PDGM). If you completed the survey, you will soon receive the full report, but we wanted to share some of the highlights with all our readers here. The following results are based on 161 respondents:

Concerns
These factors are agencies’ top concerns:

49.7%  Change from 60 day to 30 day payment periods
17.0%  Elimination of therapy thresholds
8.2%    Education of staff and management

Clinical Preparation
Agencies were asked if they were making changes in their clinical practice to prepare for PDGM, to which they responded in this manner:

21.5%   Yes, they have already started making changes in anticipation of the new model
55.7%   Not yet, but are creating a plan to be implemented when PDGM goes live
19.0%   Said that their current practices would translate into the new payment model

Help Needed
Agencies said they would need the most help in these areas:

22.9%   Understanding the impact of PDGM on their quality outcomes
45.8%   Understanding the impact of PDGM on their reimbursement
11.8%   Educating their clinical staff on the new model

We will continue to keep you up to date about this important change for our industry. Click here if you’d like to learn more about Fazzi’s PDGM Readiness Services.

Webinar Recording: Hospice SIA and Best Practices for Quality End of Life Care

CMS created the Service Intensity Add-on (SIA) in recognition of patients and families needing more intensive care and services during the last seven days of life, and that hospices must be reimbursed for these very important services. However, two years after the 2016 Hospice Payment Rule instituted the SIA, it is clear that many hospice organizations have not optimized it.

Catherine Dehlin, Fazzi’s Director of Hospice Services provides a more complete understanding of the benefit and best practice strategies to help ensure patients and families receive high quality end of life care. You’ll receive specific and actionable recommendations in these areas:

  • Direct care
  • Scheduling and staffing
  • Escalation of services
  • Care planning
  • Interdisciplinary team communication
  • QAPI

Download the handouts

Please fill out the information to view the webinar.

If you have any questions, please contact us!

PDGM Impact Analysis Now Available

We’re pleased to introduce Fazzi’s PDGM Impact Report that gives you a comprehensive analysis of the projected impact of the Patient-Driven Groupings Model (PDGM) on your agency. You’ll get the detail you need to understand what’s driving the projected change in your reimbursement and to create your PDGM Readiness plan.

Fazzi’s PDGM Impact Report provides detailed illustrations of your data – comparing the current Home Health Prospective Payment System (HHPPS) and the proposed PDGM model – with the following data points:

  • Total and average payment per episode with state and national benchmarks.
  • Number of episodes and 30-day periods with state and national benchmarks.
  • Percentage of LUPA episodes with state and national benchmarks.
  • Top primary diagnoses.
  • Top primary diagnoses not fitting into a PDGM clinical group.
  • Distribution of payments.
  • Impact by:
    • Admission source
    • Episode timing
    • Clinical group
    • Clinical group and functional level combined
    • Comorbidity
    • Location
    • HIPPS code

And! You’ll have the opportunity to speak with a Fazzi expert about your data. You can purchase a report for each of your CCNs (CMS Provider ID).

The pricing is as follows:

Quantity  Price/CCN Your Cost 
 1  $599  $599
 2  $350  $700
 3  $266  $798
 4  $225  $900
 5  $200  $1,000

To purchase reports for up to five CCNs, click here. If you would like reports for more than five CCNs, click here to speak with our Sales Department.

CMS Announces Test for Medicare Advantage Hospice Benefit Carve-In

In case you didn’t hear the news, CMS recently announced a number of Medicare Advantage (MA) health plan innovations to be tested in the Value-Based Insurance Design (VBID) model. One of those innovations to be tested for MA plans beginning in 2021 is a carve-in for hospice.

According to the CMS Fact Sheet, “Beginning in CY 2021, the VBID model will also test the Medicare hospice benefit in Medicare Advantage. CMS will release additional information and guidance on this intervention for interested stakeholders in the coming months through the VBID model website, and through open-door forum type events.”

Read the full fact sheet here.

We will continue to keep you informed of important developments for the hospice industry. In the meantime, if you’d like to learn more about Fazzi’s Hospice Consulting Services, please click here.

Home Health Compare Quality Charts Updated

The Home Health Compare results were updated on January 23, 2019.

For the Quality of Patient Care measures, 12 measures improved, 1 worsened, and 1 remained the same. As with last quarter, improvement in bed transfer saw the most improvement of 1.1%. Improvement in management of oral medications improved by 0.9%. Multifactor fall risk assessment conducted saw no change and Depression assessment conducted worsened by 0.1%. (Data Collection April 1, 2017 – March 31, 2018).

Acute care hospitalizations and Urgent, unplanned care in the emergency room both stayed the same, 15.8% at and 13.0%. (Data Collection January 1, 2017 – December 31, 2017).

The national average for the Quality of Patient Care Star Rating remained at 3.5 stars. The percentage of agencies with 3 stars declined, and the percent of agencies with 4.5 and 5 stars increased.

HHCAHPS measures also updated and the national averages remain the same. The data collection period for these measures and the Star Ratings is July 1, 2017 – June 30, 2018.

To see where the 5 star agencies are located, visit our Home Health Compare page and use the drop down for Star Ratings at the agency level. You can also compare measures by state, by year, by release date, and the top 10 or top 20 percent.

PDGM Readiness Webinar – It all Starts Here: Referrals and Intake

Wednesday, February 27 at 1:00 PM EST

Are you aware of the case mix adjuster that’s tied to referral source under the new Patient-Driven Groupings Model (PDGM)? Do you know your referral source mix and, the impact it will have on your reimbursement under PDGM? Register for the next of our complimentary webinars to learn about the admission source and timing components of the PDGM model and, the best practices for the intake, liaison and sales staff that you’ll want to start now. Plus, capturing accurate and specific information at admission is critical to assist clinicians with care planning, accuracy of primary and secondary diagnosis and the entire revenue cycle.

Join us to:

  • Understand what you and your intake, liaison and sales staff need to know now about the PDGM structure related to admission and timing.
  • Understand how to improve the working relationship between your clinical, intake and sales teams.
  • Identify the steps to take now to change your referral source mix.

Gina Mazza and Eileen Freitag will provide their best practice recommendations for referral, marketing and intake to position your agency for success under PDGM.

Register Now

OASIS-D Updates Webinar: Includes Free Bonus OASIS-D Crosswalk Tipsheet

Webinar: Tuesday, January 29 at 2:00 PM EST

OASIS-D is upon us and it’s already clear from our reviews that many of the new GG-Items are challenging clinicians. We are seeing a high number of errors that could impact future risk adjustment calculation and agency compliance with process measure data.

CMS has recently released Q&A that provides clarification related to errors that were not corrected in the final OASIS-D Guidance Manual. This new information provides much needed guidance to help agencies better understand how to correctly respond to the OASIS Items.

Join Anita Werner as she explains the new guidance and helps agencies determine how to work through areas where guidance isn’t clear. This critical 1.25 hour is a must for anyone completing the OASIS-D assessment.

Pricing:

  • COQS Certificants and full Fazzi Learning Center/OASIS Package Clients: FREE (Fazzi will distribute a link to you in a separate email).
  • All other agencies: $199 per site (includes live registration and online webinar recording). Click here to register.

For more information on becoming a Fazzi Learning Center client contact us at info@fazzi.com.

PDGM Readiness Webinar Recording: What About Therapy?

One of the biggest questions about the Patient-Driven Groupings Model (PDGM) on everyone’s mind is “what about therapy?” While the new model eliminates the therapy thresholds for payment, PDGM case mix includes mechanisms to include all disciplines.

In our complimentary PDGM Readiness webinar, Gina Mazza and Kerry Termine explain how therapy will be reimbursed in the PDGM case mix structure — and provide best practices for providing high quality patient-centered therapy services under this payment model.
Continue reading “PDGM Readiness Webinar Recording: What About Therapy?”

PDGM Readiness: What About Therapy?

One of the biggest questions about the Patient-Driven Groupings Model (PDGM) on everyone’s mind is “what about therapy?” While the new model eliminates the therapy thresholds for payment, PDGM case mix includes mechanisms to include all disciplines.

In our complimentary PDGM Readiness webinar, Gina Mazza and Kerry Termine explain how therapy will be reimbursed in the PDGM case mix structure — and provide best practices for providing high quality patient-centered therapy services under this payment model.

Continue reading “PDGM Readiness: What About Therapy?”