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.
Industry Insights
Fazzi Associates provides the home health and hospice industry with insights and new developments that will be beneficial to the success of your agency. This information can be sent to you automatically…and it’s free! The insights, data, white papers and webinars are specific to home care and hospice and will be beneficial to the success of your agency.
No other company offers the home health and hospice industry as much expertise, tools, principles and wisdom. Only Fazzi integrates national best practice research findings into all of our communications and services with the mission of helping agencies substantially make improvements and build strength in four key areas: profitability, quality, efficiency and growth.
Webinar: Targeted Probe and Educate in Hospice – Learn How to Prepare
Fazzi has partnered with WellSky to present this free webinar.
As the regulatory scrutiny of hospice care continues to intensify, Medicare Administrative Contractors (MACs) are identifying hospices for Targeted Probe and Educate (TPE) in record numbers. While the Targeted Probe and Educate program is intended to impact providers (and ultimately patient) in positive ways, these reviews can be time consuming, challenging, and stressful for hospice leaders. How will you prepare if your hospice is identified for a TPE?
In this important 60-minute presentation, Catherine Dehlin, RN, BSN, CHPN, CHCM, Director of Hospice, will help you understand TPE and learn how to get the most out of this important process.
Attend and learn:
- The rationale and objectives of TPE in hospice
- The typical TPE process for most MACs and the ideal response for hospice providers
- The aspects of hospice performance that agency leaders should monitor regularly
Don’t miss this opportunity for you and your team to learn from one of hospice’s most influential thought leaders!
How Many More Claims Will You Need to Bill Under PDGM?
One of the many sweeping changes under the Patient-Driven Groupings Model (PDGM) is the move to 30-day payment periods. Diane Poole, long time industry expert and the Director of Fazzi’s outsourced billing department, has created a position paper to address the implications of this change on billing capacity and cash flow. Specifically, in this position paper you’ll learn:
- Predictions on increased claim submissions by agency size (based on CMS data) and how that impacts the associated workload in your billing department.
- The impact on cash flow from “Half the RAP”.
- How Fazzi will help our outsourced billing clients with these challenges.
Continue reading “How Many More Claims Will You Need to Bill Under PDGM?”
What the FY 2020 Proposed Rule Means for PDGM and Coding
CMS has issued the FY 2020 Proposed Medicare Home Health Payment Rule which of course encompasses far more than the proposed payment rates. In particular, the industry has wondered what, if any, changes CMS would make to the Patient-Driven Groupings Model (PDGM) set to go into effect on January 1.
In this complimentary webinar, we provide an update on the portion of the Rule that encompasses PDGM and in particular what we believe to be the impact on agencies’ coding operations, challenges and imperatives.
Hospice Compare Updated
CMS posted the quarterly Hospice Compare refresh of quality data on August 15, 2019.
All quality measures improved since the last quarterly posting or stayed the same. Pain Assessment and Composite Process Measure showed the most improvement each with a 1.1% increase. Pain Assessment improved from 89.2% to 90.3%, and Composite Process Measure, from 85.3% to 86.4%.
A new quality measure, Hospice Visits When Death Is Imminent, has been added and posted at 82.3%. This measures the percentage of patients getting at least one visit from a registered nurse, a physician, a nurse practitioner, or a physician assistant in the last 3 days of life.
Updates to the family caregivers’ survey results showed all eight measures remained the same.
Quality measure results are from data collected October 1, 2017 – September 30, 2018, and Hospice CAHPS® survey results reported October 1, 2016 to September 30, 2018.
Understanding the Hospice Final Rule
Fazzi has partnered with WellSky to present this free webinar.
The Centers for Medicare & Medicaid Services (CMS) have published the 2020 Hospice Final Rule, which includes a significant rebasing of hospice payment rates. Rates for higher acuity levels of care are increasing, while rates for routine home care are decreasing. The 2020 final rule also includes a complex new requirement for an addendum to election statements that must provide details as to the care, services, and drugs that will not be covered under the Medicare hospice benefit.
Implementation of the election addendum has been delayed until October 2020, but other provisions of the 2020 hospice final rule go into effect on October 1, 2019, so your time to prepare is very brief. The time to begin is now.
In this important 60-minute presentation, Catherine Dehlin, RN, BSN, CHPN, CHCM, Director of Hospice Services for Fazzi Associates will help you understand the new requirements, evaluate their impact on your processes, and create an action plan to succeed.
Watch to learn:
- How rebased payment rates for CHC, IRC, and GIP levels of care will affect your hospice
- Why rebased payments may signal a new level of compliance scrutiny for hospices
- The new requirements for an addendum to the hospice election statement
Fazzi’s Summary and Response to the OIG’s Hospice Reports
As you probably know, the US Department of Health and Hospitals Office of Inspector General (OIG) recently released a two-part report that reviewed hospice deficiencies across the nation from 2012-2016.
These reports are long, and there has been a great deal of media attention about them. We thought it would be useful to you to have an objective and digestible summary, and so we’re pleased to provide just that. In this paper from Catherine Dehlin, our Director of Hospice Services, you’ll find:
- An objective summary of the two reports released by OIG.
- CMS’ responses to the OIG’s recommendations to CMS.
- Fazzi’s response.
Simplified PDGM Look-Up Tool Updated from Proposed Rule
We’re pleased to tell you that we’ve updated the Simplified PDGM Impact Look-Up Tool – a fast and easy way to see CMS’ updated projection of the financial impact of PDGM on your agency.
This Look-Up Tool accesses CMS’ Agency Level Impact projections updated with 2018 claims and 2020 proposed payment rates incorporated into the Proposed 2020 Home Health Payment Rule released July 18, 2019.
Home Health Compare Updated
The Home Health Compare results were updated on July 24, 2019.
For the Quality of Patient Care measures, 11 measures improved and 3 remained the same. Improvement in bed transfer and improvement in management of oral medications saw the most improvement of 0.9%. Multifactor fall risk assessment conducted, depression assessment conducted and influenza immunization received for current flu season saw no change. (Data Collection October 1, 2017 – September 30, 2018).
Acute care hospitalizations and urgent, unplanned care in the emergency room both stayed the same at 15.8% and 13.0%. (Data Collection January 1, 2017 – December 31, 2017).
The national average for the Quality of Patient Care Star Rating remained the same at 3.5 stars. The percentage of agencies with 2,3 and 4 stars declined and the rest increased.
HHCAHPS measures also updated and the national averages remain the same for 3 measures. Patient willingness to recommend and overall rating of care given by HHA’s care providers improved by 1%. The data collection period for these measures and the Star Ratings is January 1, 2018 – December 31, 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.
Hospice Compare Updated
CMS has posted the quarterly Hospice Compare refresh of quality data on May 23, 2019. All quality measures improved since the last quarterly posting or stayed the same. Pain Assessment showed the most improvement, from 87.8% to 89.2%, followed by Composite Process Measure.
Updates to the family caregivers’ survey results showed seven measures remained the same. However, ‘Willing to recommend this hospice’ decreased by 1%.
Quality measure results are from data collected July 1, 2017 – June 30, 2018, and Hospice CAHPS® survey results reported July 1, 2016 to June 30, 2018.
| View State Level Hospice Compare Charts |