April Compliance Newsletter

Key Drivers for Improving the Overall Results of Hospice CAHPS Results

Amid challenging new regulations and escalating reimbursement constraints, why is the Hospice CAHPS® survey good for hospice? Gina Mazza, Partner, Director of Regulatory and Compliance Services at Fazzi outlines the four important reasons Hospice leaders should consider CAHPS when setting strategic goals. Learn more by downloading the white paper, CAHPS: Why it’s Good for Hospice!

CoPs Delayed and PreClaim Stopped

As you’ve probably heard, CMS paused Pre-Claim Review in Illinois, postponed indefinitely its start in Florida and the other states and issued a proposed rule that will change the new CoP rule effective date to January 13, 2018. The industry is abuzz with questions and Fazzi has the answers. To get the latest facts and learn what you should be doing now, regardless of these change, Fazzi recently provided a brief executive update webinar. View the webinar recording.

The Tricks of Transfers

M1850-Bed to Chair Transfer is one of the most challenging OASIS questions. The language used in the responses is particularly ‘tricky’. This is one of the few instances in OASIS where “OR” actually means “OR” and not “AND”. Response #1 indicates a patient requires minimal assistance or the use of an assistive device. It’s important to remember Response #1 cannot be selected when a patient needs both assistance from a person and an assistive device. Instead, select Response #2. This response indicates a person can both bear weight and pivot but can’t transfer themselves without more than minimal assistance from another person. The actual wording of the response reads “unable to transfer self” and this makes clinicians hesitate to select the response. Guidance is very clear on this from Q&A releases. Don’t miss your opportunity to show outcome improvements and proper reimbursement!

Fazzi Can Help You Improve Your Return Rate

Did you know that Fazzi offers Mixed Mode data collection for Home Health and Hospice CAHPS? Fazzi’s CAHPS Mixed Mode return rate is higher than the national average – coming in at around 40%! With patient and family satisfaction so important to Star Ratings and Value-Based Purchasing and public reporting of Hospice CAHPS right around the corner; response rates are important. To learn more, contact us.

CAHPS: Why it’s Good for Hospice!

Amid challenging new regulations and escalating reimbursement constraints, why is the Hospice CAHPS® (Consumer Assessment of Healthcare Providers and Systems) survey good for hospice? Here are the four important reasons Hospice leaders should consider CAHPS when setting strategic goals:

This is standard tool that brings hospice in line with the healthcare continuum.

CAHPS surveys – for hospitals, home health providers, Medicare Advantage programs, prescription drug plans, in-center hemodialysis centers, Medicare ACOs, and adult Medicaid programs, and most recently hospices – ask patients and/or caregivers to report on and evaluate their experiences with health care. Data for most providers is reported to the public to help consumers and referring healthcare providers make choices about where they would prefer to receive care. Continue reading “CAHPS: Why it’s Good for Hospice!”

HHS Ahead of Schedule with Value-Based Payment Models: Audits Can Help Agencies Prepare

To help drive the health care system towards greater value-based purchasing rather than continuing to reward volume regardless of quality of care delivered, HHS set a goal in 2015 to have 30 percent of Medicare payments in alternative payment models by the end of 2016 and 50 percent by the end of 20181. In March 2016, the Administration announced that it estimates it has already hit its first target – 11 months ahead of schedule2. There’s no doubt that the home health fee-for-service payment model is quickly being replaced with payments tied to quality of care results with increasingly rigorous scrutiny. Unfortunately, as reported in Home Health Care News, our data indicates that many home health agency staff continue to struggle with obtaining accurate OASIS assessments which will drive many outcomes, revenue and compliance activities.

Fazzi’s Compliance Division recently completed an analysis on the home health coding and OASIS audits they conducted over the past 12 months. The study revealed that on average $150-$200 per episode was not captured by agencies because of inaccurate completion of the OASIS! Furthermore, it appeared that multiple outcome measures did not show improvement because of inaccurate OASIS selection at the start of care.

Given the price of inaccurate OASIS documentation, understanding how your clinicians are handling the OASIS and which areas are most problematic is a key component to your Agency’s success.  Consider conducting a targeted record audit. Our audit will:

  1. Likely pay for itself,
  2. Tell you quickly if your OASIS assessments are accurate, and
  3. Indicate which areas should be prioritized for improvement.

Only after you know that your OASIS assessments are accurate, should you identify 1-2 QA/PI projects focused on improving quality of care measures.

Contact us about the cost and options for a focused OASIS audit.

Key Drivers & Best Practices for Improving HHCAHPS Results

Since the Home Health CAHPS (HHCAHPS) results were first publicly reported on Home Health Compare (HHC) in April 2012, the impact and consequence for performing poorly on HHCAHPS measures has changed significantly. Home Health Agencies are now accountable for their performance on quality of care and patient experience outcomes in a public and increasingly competitive manner. Consider that in the last few years our industry has adopted a publicly available Star Rating display on a set of patient care outcomes as well as patient experience/satisfaction outcomes. Much like shopping for any other service, the star ratings can and will impact a patient and/or caregiver’s decision on which agency they will consider to receive care.

Continue reading “Key Drivers & Best Practices for Improving HHCAHPS Results”