The changes the home health industry has endured under PDGM have affected every part of your agency. After a month of focusing on changes to OASIS and documentation, it’s now time to spend time focusing on the back office.
One of the many sweeping changes put in place under PDGM was the move to 30-day payment periods. This change has major implications for nearly every part of your agency. Shorter cycles will likely have increased the number of claims that your billing department submits.
To keep up with the increased number of claims, your billing process must be efficient. Use this tip sheet to learn why your agency should focus on:
- The process for orders management
- Timely OASIS documentation and submission
- Standardizing the process for correcting bill-edit errors
As the population ages and the demand for hospice and palliative care grows, hospice agencies are faced with regulation changes as the Centers for Medicare and Medicaid Services (CMS) aim to create a care continuum focused on value-based care.
With PDPM and PDGM already implemented in the connected spaces of long-term care and home health, hospice agencies should be sensing greater change on the horizon. Monitoring 2019 industry topics and trends predicted to impact hospice agencies in 2020 is the first step to get ahead and stay ahead of the competition.
In this detailed report, Catherine Dehlin, RN, BSN, CHPN, CHCM, COQS, Director of Hospice and Palliative Services for Fazzi Associates, breaks down some of the biggest trends that hospice agencies will face in 2020.
Download this free white paper to learn:
- How pending federal legislation will impact agencies
- Why new assessment tools will be used and how they will impact every facet of the industry
- What factors are impacting the financial outlook of the hospice market
PDGM is a major regulatory change that will impact every aspect of your agency. As each department prepares for inevitable changes, it’s important to ensure your agency is on track as whole. To do this, you must prioritize tasks.
With 30 days left until PDGM is implemented, it’s important to prioritize tasks that help create a sense of normalcy at your agency. Staff, no matter the department, need to start creating habits that make new policies and procedures second nature. Fazzi’s 30-day PDGM timeline can help you do just that.
Download the tip sheet to learn:
Why December 27th is an important date for you and your team
- Why testing the claims process in your agency’s software is critical for success
- How a decision team can help you track your agency’s PDGM progress
For years the base-payment rate for the level of care provided by hospice agencies has remained unscathed by large-scale adjustments. After identifying misalignment through regulation changes, CMS realized something needed be done to help create payment accuracy.
To better align base-payment rates, the CMS 2020 hospice final rule includes a significant rebasing of hospice payment rates. In this free white paper, Catherine Dehlin, RN, BSN, CHPN, CHCM, COQS, Director of Hospice and Palliative Care Services at Fazzi Associates, explains the history of hospice rebasement and how the new alignments can impact your agency.
Download the free white paper to learn:
- Why realignment of hospice repayment was needed
- How repayments have changed
- How your hospice agency will be affected
- What your agency should do to lessen the financial impacts of these changes
The 2020 PPS final rule was posted to the Federal Register confirming plans to implement the Patient-Driven Groupings Model (PDGM) beginning January 1, 2020.
The good news is that CMS has cut back on plans to implement an 8.01% decrease in agencies’ payments. Instead, they are finalizing a 4.36% decrease based on assumed behavioral changes and have made some other small revisions. Most other updates, including the elimination of therapy thresholds as a factor of payment, the move from 60 day episodes to 30 day payment periods, and the factors determining case-mix and clinical groups will remain the same. Agencies can click here to review the final rule.
Join Fazzi for a free webinar session where we will:
- Review key concepts as described in the final rule with Fazzi expert Gina Mazza, MBA, RN, BSN, Senior VP of Quality and Compliance, as she discusses finalized guidance regarding PDGM.
- Provide participants with concrete strategies to prepare for PDGM and be ready for implementation on January 1st.
- Hear from one agency as they discuss what their organization is doing now to prepare and services they are using to ensure they are PDGM ready on day 1.
PDGM is a major regulatory change that will impact every aspect of your agency. As each department prepares for inevitable changes, it’s important to ensure your agency is on track as whole.
To do this, you must prioritize tasks. To help prioritize tasks, it’s important to understand where you should focus your resources. Fazzi’s PDGM timeline can help you do just that.
Download the tip sheet to learn:
- Why department specific team meetings will help your team prepare for PDGM
- Why December 27th is a date that should be on your agency’s radar
- What coding best practices should be in place for your agency’s success
The Home Health Compare results were updated on October 30, 2019.
For the Quality of Patient Care measures, 10 measures improved and 4 remained the same. Improvement in management of oral medications saw the most improvement of 0.9% and improvement in bed transfer improved by 0.8%. (Data Collection January 1, 2018 – December 31, 2018).
Acute care hospitalizations and urgent, unplanned care in the emergency room both improved at 15.6% and 12.8%. (Data Collection January 1, 2018 – December 31, 2018).
The national average for the Quality of Patient Care Star Rating remained the same at 3.5 stars.
HHCAHPS measures also updated and the national averages remain the same for all 5 measures. The data collection period for these measures and the Star Ratings is April 1, 2018 – March 31, 2019.
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.
The Centers for Medicare & Medicaid Services (CMS) issued the 2020 final rule on October 31, reinforcing the plan to implement the Patient-Driven Groupings Model on January 1, 2020. With PDGM just 60 days away and so much to do in so many departments, it can be hard to know what tasks should be prioritized over others.
To help prioritize tasks, it’s important to understand where you should focus your resources. Fazzi’s PDGM timeline can help you do just that. Download the tip sheet to learn:
- Why you should focus on referral and intake workflows
- Why developing a Significant Change in Condition Policy is important
- What you should be doing to ensure your software is PDGM ready
PDGM is quickly approaching. To prepare, home health agencies will need to make significant changes to their operations. Failure to adapt and respond to these regulatory changes put agencies’ revenue at risk from both a reimbursement and profitability perspective.
PDGM will illuminate the need for strict compliance and accuracy when submitting claims.
Download this free white paper to learn more about the three broad areas agencies must address to successfully manage claims to ensure proper reimbursement under PDGM. The areas addressed in this white paper include:
- Recognizing the twelve clinical sub-groups and unacceptable primary codes
- Identifying common home health codes under each sub-group
- Understanding the steps to prepare coders for PDGM coding
Coding is one of the most important aspects of your agency’s operations. Errors in coding can cause delays in reimbursement, or worse – denials. Reimbursements are the key to financial stability, and this stability allows you to deliver care at the highest levels.