Tip Sheet: Key focus areas – 30 days to PDGM Implementation

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

Hospice Payment Rebasing

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

Tip Sheet: Key focus areas – 45 days to PDGM Implementation

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

Tip Sheet: Key focus areas: 60 days to PDGM implementation

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

Guidance for home health agencies to address PDGM

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

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?”

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.

PDGM Readiness: Fazzi’s Answers to Questionable Encounters

Fazzi’s Findings and Advice about Questionable Encounters: A Complimentary Position Paper

One of the biggest concerns for agency leaders around the Patient-Driven Groupings Model (PDGM) is the issue of submitting claims with primary diagnoses that do not fit into one of the 12 clinical groupings in the payment model.

Read our position paper on this topic to learn:

  • Fazzi’s findings about questionable encounters from our own database.
  • How Fazzi is helping our outsourced coding clients to minimize questionable encounters.
  • Important compliance considerations.

Continue reading “PDGM Readiness: Fazzi’s Answers to Questionable Encounters”

PDGM Readiness White Paper: It Begins with Leadership

Everyone knows that the Patient-Driven Groupings Model (PDGM) is the most sweeping change for Home Health since the Prospective Payment System (PPS), and industry veterans certainly remember that period of uncertainty and disruption.

With PDGM, yet again, every Home Health agency will need to adjust. And while you’ll need to analyze the impact on every core function, “step one” is to realize that what’s most important is leadership and the ability to manage change. Gina Mazza’s white paper, “Step One to PDGM: Leadership and Change Management” offers a “PDGM leadership checklist” to help get you started.

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Understanding the 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 at the very end of life. The SIA also recognizes the higher costs of those services by offering hospice providers reimbursement for them. Specifically, the SIA payment covers direct care provided by a registered nurse or social worker that occurs during the last seven days of life, up to four hours per day, in addition to the routine home care per diem reimbursement.

However, two years after the 2016 Hospice Payment Rule instituted the SIA, it is clear that many hospice organizations have not realized the opportunity for optimizing the reimbursement model, enhancing care during the last seven days of life and capturing the SIA payment.

Fazzi’s complimentary white paper written by Catherine Dehlin, Fazzi’s Director of Hospice Services entitled, “Does Your Hospice Team Understand Service Intensity Add-On?”, 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. This paper is full of specific and actionable recommendations in these areas:

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

Following these recommendations will benefit patients and their families as well as help agency leaders access this important resource.

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