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”

Is Coding Holding Your Agency Back?

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?”

Managing the Workforce Crisis: First Do No Harm! Build Competence & Confidence to Retain Clinicians

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”

Managing the Workforce Crisis: First Do No Harm! Creating Optimal Culture

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”

Supply and Demand for Key Positions (If you were worried about nursing, wait until you see the Home Health aide projections!)

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 (If you were worried about nursing, wait until you see the Home Health aide projections!)”

The Many Facets of Optimal Staffing

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”

PHI and Cyber Security in Outsourced Services

As the trend towards outsourcing continues to grow, an important consideration is the need to keep Protected Health Information (PHI) secure and to mitigate cyber security risks.

According to the Sixth Annual Benchmark Study on Privacy & Security of Healthcare Data, conducted by the Ponemon Institute in 2016, nearly 90% of healthcare organizations suffered a data breach in the past two years and “criminal attacks from the outside and negligence from the inside continue to put patient data in the crossfire.”

Download our complimentary white paper on this topic by Melanie Duerr, Partner and Director of Fazzi’s Coding Operations, and Jami Fisher, Chief Information Officer, as they explain cyber security issues and risks and how to mitigate them when outsourcing.

Continue reading “PHI and Cyber Security in Outsourced Services”

CAHPS: Why it’s Good for Hospice!

Amid challenging new regulations and escalating reimbursement constraints, why is the Hospice CAHPS® (Consumer Assessment of Healthcare Providers and Systems) survey good for hospice? Here are the four important reasons Hospice leaders should consider CAHPS when setting strategic goals:

This is standard tool that brings hospice in line with the healthcare continuum.

CAHPS surveys – for hospitals, home health providers, Medicare Advantage programs, prescription drug plans, in-center hemodialysis centers, Medicare ACOs, and adult Medicaid programs, and most recently hospices – ask patients and/or caregivers to report on and evaluate their experiences with health care. Data for most providers is reported to the public to help consumers and referring healthcare providers make choices about where they would prefer to receive care. Continue reading “CAHPS: Why it’s Good for Hospice!”

Key Drivers & Best Practices for Improving HHCAHPS Results

Since the Home Health CAHPS (HHCAHPS) results were first publicly reported on Home Health Compare (HHC) in April 2012, the impact and consequence for performing poorly on HHCAHPS measures has changed significantly. Home Health Agencies are now accountable for their performance on quality of care and patient experience outcomes in a public and increasingly competitive manner. Consider that in the last few years our industry has adopted a publicly available Star Rating display on a set of patient care outcomes as well as patient experience/satisfaction outcomes. Much like shopping for any other service, the star ratings can and will impact a patient and/or caregiver’s decision on which agency they will consider to receive care.

Continue reading “Key Drivers & Best Practices for Improving HHCAHPS Results”

Should We Be Worried About Our Field?

I feel I have a responsibility, one garnered from nearly forty years in this field to honestly express what I see and feel related to how we as an industry are approaching our future.  From this perspective I want to respectfully say I believe that as an industry and as leaders, we are not doing enough.  We are not coming together to aggressively take responsibility for redefining, reshaping and re-energizing our field.  As an industry, we seem to be passively watching while others define us.

Continue reading “Should We Be Worried About Our Field?”