It’s Time to Answer the Phone!

The phone calls are about to begin! By that I mean the phone survey calls for the 2016 National Home Care and Hospice State of the Industry Study.

With over 1,700 suggestions from you and your colleagues across the country, the questionnaire is now complete and we are about to begin making the survey calls. Every agency that participates will receive an advance copy of the findings to be released this fall. If you would like to volunteer to participate, you may do so by clicking this link.

This is our fourth biannual State of the Industry Study. Given the new world of Value-Based Purchasing and the inevitable Pay-For-Performance model that will be mandated nationwide, there is no question it will be the most important. Everything about this project is designed to help agencies improve quality and lower costs, because we know that the Invincible agencies will be those who embrace “who we were yesterday cannot be who we are tomorrow.”

I am so pleased and thankful for all of the input we received from the industry in designing this study.  A sampling of topics includes:

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Fazzi’s National OASIS Testing Project Preliminary Results

8e908b30-d157-4786-80f5-e543854dfdd0Well, we made it, at least season-wise.  Spring!  It is absolutely my favorite time of the year.  It always feels like a new beginning.  It is not just the more pleasant temperatures, it is the excitement of seeing buds emerging on trees, birds returning to New England and the first signs of flowers.  Longer days and more sun makes it especially exciting for our colleagues in northern states.

Unfortunately, what hasn’t changed are the demands on our agencies, especially data demands.  This month I’d like to touch on a few different topics that share a common thread – research, data and the importance of continuous learning (the fun part!).

Our industry is flooded with data demands.  Data that must be reported.  Data that affects STAR ratings.  Data that impacts reimbursement and quite frankly could possibly threaten the existence of some agencies (especially in the Value-Based Purchasing pilot states).  That’s exactly why we’re so intent on providing research and data that fuels insight, learning, and improvement.

Let’s take a look at some research that we feel is important and telling.  First, as you may recall, we are currently conducting a national OASIS testing project to test agency staff competencies around OASIS across the country, and we have some preliminary results to share.  (Note that if you haven’t participated in this testing, please see the next article.)

Fazzi’s National OASIS Testing Project Preliminary Results:

Average score by position:

  • Manager 71%
  • PT 75%
  • RN 73%
  • Auditor 81%

Average score for those items impacting Value-Based Purchasing (VBP) and STAR Rating: 77%

Biggest problem areas are those that impact VBP/STAR scores:

  • ADL/IADL average score: 62%
  • Respiratory Status (specifically M1400) score: 54%

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February 2016 Newsletter

The Threat (and the Opportunity) Is Real

Bob Fazzi

Each year we are faced with regulatory and reimbursement changes and challenges that make it more difficult or more expensive to provide services. Some are troubling and time consuming while others threaten the viability of some agencies. Every new challenge is often followed by cries that these are “industry altering” threats. Think about introduction of OASIS. RAC audits. Face to Face. Rebasing.

Don’t get me wrong, these are serious challenges but they don’t reach the magnitude of “industry altering.” Today, however, there is a real threat, one that has the potential of becoming the third home care challenge that could reach the status of industry altering. It is a threat that will start in nine states (AZ, FL, IA, MA, MD, NC, NE, TN, WA) and will ultimately expand to all fifty states. First, a little history.

Industry Altering Challenge I. The Medicare Denial Crisis

The first Industry Altering threat was caused by the service and payment denials of the late 80s and early 90s. Basically, agencies found that many of their services were denied. Denied meant no payments. No payments meant agencies could not pay bills and staff. Results: closures. Many closures.

Following a major lawsuit lead by the National Association for Home Care and Hospice, the problem was rectified, the definition of eligible services expanded and our industry began experiencing significant growth in numbers of agencies, patients served and revenues. Great stability for roughly 18 years…and then the second challenge emerged.

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December 2015 Newsletter

Message From Bob: I Feel Privileged!

Bob FazziAs I was preparing to write this column, I realized that I had two choices.  One option was to write about our predictions for 2016.  Let’s face it, with so much now occurring and about to occur, it would be a very juicy, interesting column.  Think of this as the “business” of Healthcare at Home option.

The other option, some would say the syrupy, reflective option, would be to look back and comment on the importance of home care and our role in making our communities, our state and our country a better place for all of us, not just our patients but their children, families and friends.  Think of this as the “mission” of Healthcare at Home.  I chose the latter!

We are so caught up with the challenges of face-to-face, STARS program, bundled payments, movement to ICD-10, CMS audits, cost reductions, etc., we seem to have no time to stop and reflect on how important we are for the millions and millions of patients in our home care, hospice and private duty programs.  There is not a community in this country where one of our staff have not been there at one time or another to serve a member of family in that community.

Every day, every hour, every minute someone in our field is serving a patient whose life is made better, more tolerable because we are there.  Every day, every hour, every minute there is a family who is experiencing a sense of reassurance because a caring person drove to their home and shared their talent and compassion to help their love ones.  And every day, every hour and every minute there is not a community in this country that is not made stronger because we are there.  We are a key component of the social fabric of this country.

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November 2015 Newsletter

Message From Bob Fazzi

It’s time to take the future of home care seriously.  Here is why.

If you ask any one on your management staff who was working in home care on August 5, 1997 what happened on that date, most would tell you it was one of the worst times in the history of home care—the Balanced Budget Act went into effect.  Over 1/3 of all agencies were forced to close and home care lost 50% of its projected revenue as our industry moved from pay per visit to episodic payments.  The agencies that did not survive did not move quickly enough.

Value-Based Purchasing is just as serious and has the potential of being just as destructive. There will be agencies that come out ahead, and those that go out of business.  The difference is in how you prepare.

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September 2015 Newsletter

Should We be Worried About Our Field?

Let me start by saying, I love this field.  Home Care and Hospice is a critical sector of health care and a social pillar of our society.  I am awed by the leaders I work with and indebted to the hundreds of thousands of caregivers and support staff who make our agencies what they are today.  And, I am humbled and grateful that I have had the good fortune of being involved in a field I consider sacred and so important.

At the same time, 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.

The fact is that the community will inevitably be the focus of healthcare in this country and world-wide.  There is no choice!  The aging of the population, the exponential growing numbers of seniors and the spiraling cost of health care make it imperative that the future of healthcare be provided in the sector that can provide the highest quality healthcare services for the highest number of patients at the lowest cost.

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