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?”
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.
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”
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.
Continue reading “PDGM Readiness White Paper: It Begins with Leadership”
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
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”
New Reasons to Outsource or to Examine Your Coding Vendor
The trend of outsourcing the coding function has been gaining momentum among home health and hospice agencies for a number of years. And now, with OASIS-D, the Patient-Driven Groupings Model (PDGM) and the changing regulatory landscape for hospice, the list of reasons to outsource – or to examine your coding vendor – is getting longer.
Our white paper entitled, “Is Coding Holding Your Agency Back?” provides important insights on this industry trend including a list of questions to ask your prospective or current coding vendor. Authors Kelly Murphy-Miller and Kerry Termine have packed a lot of information into a very readable five pages
Continue reading “Is Coding Holding Your Agency Back?”
Edition #4 of the White Paper Series, The Workforce Crisis: Information and Strategies for Optimal Home Health and Hospice Staffing
In this edition we discuss how leaders can support their clinicians and arm them with training and tools for success in the field.
Continue reading “Managing the Workforce Crisis: First Do No Harm! Build Competence & Confidence to Retain Clinicians”
Edition #3 of the White Paper Series, The Workforce Crisis: Information and Strategies for Optimal Home Health and Hospice Staffing
In this edition, we discuss the importance of culture in attracting and retaining employees, especially Millennials. In our work with agencies across the country, we have observed many organizations that unintentionally and unknowingly make their own workforce challenge worse…
Continue reading “Managing the Workforce Crisis: First Do No Harm! Creating Optimal Culture”
Edition #2 of the White Paper Series, The Workforce Crisis: Information and Strategies for Optimal Home Health and Hospice Staffing
In this edition, we look at the projected supply and demand for key positions in home care and hospice. We also introduce a one-stop resource to view state by state data on Registered Nurses (RNs), Home Health Aides (HHAs), Personal Care Aides (PCAs), Licensed Practical Nurses (LPNs), Licensed Vocational Nurses (LVNs) and Physical Therapists (PTs)…
Continue reading “Supply and Demand for Key Positions”
Edition #1 of the White Paper Series, The Workforce Crisis: Information and Strategies for Optimal Home Health and Hospice Staffing
Home Health and Hospice agency staffing concerns are growing rapidly along with the aging population we serve. Agencies of all sizes are reporting record numbers of vacancies, suppressing revenue and continuum based Care Management. There are numerous studies, some conflicting, on supply and demand for RNs. A recent study by Fazzi confirms workforce challenges are among the top concerns of agency leaders across the country. Many people are calling it a crisis. Continue reading “The Many Facets of Optimal Staffing”