Industry Insights

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.

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.

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.

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

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?” →

CMS has posted the quarterly Hospice Compare refresh of quality data on December 4, 2018. All quality measures showed improvement since the last quarterly posting! Pain assessment showed the most improvement, from 83.4% to 85.5%, followed by pain screening.

Updates to the family caregivers’ survey results showed seven measures remained the same.

CMS has added a new “Composite Process Measure” to Hospice Compare. As of this release, the national average is 83.6%.

Quality measure results are from data collected 1st quarter 2017 through 4th quarter 2017, and Hospice CAHPS® survey results reported 1st quarter 2016 through 4th quarter 2017.

View State Level Hospice Compare Charts