Home Health, Hospice & Regulatory Blog
The HEALTHCAREfirst blog offers insights and updates to help home health and hospice professionals stay informed. From regulatory news to best practices and tips, we are committed to the success of our customers and the industry as a whole.
Administrative costs account for 1/3 of healthcare expenditures in the United States. While this number takes into account many other types of healthcare, home health and hospice administrative costs were included in this often cited and quite comprehensive study published in the New England Journal of Medicine. In fact, CMS recently introduced regulatory changes to
On September 17th, CMS held a public event to share its proposal to reform several home health and hospice regulatory requirements. The proposal includes changes to current home health and hospice regulatory requirements, Conditions of Participation (CoPs), and Conditions for Coverage. According to CMS, this will “simplify and streamline the current regulations and thereby increase provider
Many agencies face the same common barriers to home health and hospice success. But you may only be a few changes away from overcoming these barriers. Here are five common barriers, and how you can avoid them. Poor Use of Resources Even the best home health and hospice agencies can run into trouble if they
Since the pause of the Pre-Claim Review Demonstration in April 2017, CMS has been working to develop an alternative called the Review Choice Demonstration. It states that this new demonstration will, "offer more flexibility and choice for providers, as well as risk-based changes to reward providers who show compliance with Medicare home health policies." Participation is
On August 1, 2018, CMS issued the FY2019 Hospice Final Rule for Medicare hospice agencies. The final rule includes changes to the hospice payment rates as well as updates to the Hospice Quality Reporting Program (HQRP). Burden Reduction CMS will no longer display the seven component measures from which a composite measure is calculated on
On June 11, 2018, the Centers for Disease Control and Prevention (CDC) released the FY 2019 ICD-10-CM code changes. There are 473 code changes, including 279 new codes, 143 revised codes, and 51 deactivated codes. These codes are to be used from October 1, 2018 through September 30, 2019. What is included in the 2019
Data is emerging as a critical component of operational success across a wide range of industries, and home health care isn't exempt from this movement. A CIO magazine report said that the health care industry as a whole is in the middle of a movement to embrace the prospect of gleaning new insights from the large quantities of
On July 2, 2018, CMS released the 2019 Home Health Proposed Rule. It includes considerable proposed changes to the Home Health Prospective Payment System designed to “strengthen and modernize Medicare, drive value, and focus on individual patient needs rather than volume of care.” Payment Rate Changes for CY2019 CMS projects that Medicare payments for CY2019
On June 7, 2018, CMS announced improvements to the hospice NOE process for hospice elections received on or after July 2, 2018. A new hospice election period format will be added to the Common Working File (CWF) system to carry election-related information. The existing hospice benefit period screens will continue to look the same, but
Having a Quality Assurance and Performance Improvement (QAPI) program is mandated by the new Home Health Conditions of Participation (CoPs). While home health agencies should already have their QAPI programs up and running, you have until July 13, 2018 to implement and document at least one performance improvement project (PIP) to ensure compliance with the
Managing a successful hospice agency is no simple task. It involves many processes aimed at streamlining workflow, effectively managing employees, accurately and securely completing paperwork, all while providing patients and their loved ones with the highest quality of care. With so many elements involved, it can be easy to become overwhelmed. However, when you partner
With increased transparency to the public eye, hospices have an even greater incentive for hospice quality performance improvement, as well as an opportunity to shine in a competitive market. Here are three essential tips that you can use for hospice quality performance improvement. 1. Utilize Any & All Available Hospice Quality Performance Improvement Reporting Data
In this blog post, we will discuss what the pre-claim review demonstration is, the history of pre-claim review, and the latest updates. In June 2016, CMS announced implementation of a three year Home Health Pre-Claim Review Demonstration. The demonstration was designed to test whether a Pre-Claim Review (PCR) process would improve the identification, investigation, and
While many home health agencies work hard to improve HHCAHPS survey scores, they should also focus on techniques to improve their HHCAHPS survey response rate. As an industry-leading HHCAHPS survey provider, we are often asked, “How many responses do I need?” CMS requires at least 20 completed surveys per reporting period for public reporting on
Over the years, our industry has seen reports of crimes related to Medicare fraud including conspiracy to commit health care fraud, violations of the anti-kickback statutes, and money laundering. Recently, the OIG released its Health Care Fraud and Abuse Control Program Report for FY2017. In its report, the OIG discusses several significant criminal and civil investigations
On April 27, 2018 CMS released the FY2019 Hospice Proposed Rule. The rule includes a proposed increase in hospice reimbursements as well as changes to the Hospital Quality Reporting Program (HQRP), although no new measures are proposed. Highlights of the FY2019 Hospice Proposed Rule include: Payment Update CMS is proposing a 1.8% increase in reimbursements to
What good is powerful software without multi channel customer service and support available when you need it? Web-based home health and hospice software has many advantages including minimal upfront costs, rapid development cycles with immediate updates, no downtime for server maintenance, and the ability to use a variety of devices from anywhere, at any time.
Hospital readmission reduction is a hot topic in healthcare these days. Studies show that nearly 20% of Medicare recipients discharged from a hospital were readmitted within 30 days, with 34% readmitted within 90 days. MedPAC has estimated that 12% of readmissions are avoidable, and preventing even a small portion of these readmissions could save Medicare
Designed to help protect the privacy of Medicare recipients, a new Medicare Beneficiary Identifier (MBI) will replace the social security number-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim FISS/DDE submissions starting April 1, 2018. Beginning in April, CMS will mail new Medicare cards to all people with
The hospice interdisciplinary team (IDT) serves a very important function in hospice care. It includes physicians, nurses, home health aides, social workers, counselors, chaplains, therapists and trained volunteers who work together to address a hospice patient’s physical, emotional, and spiritual needs. The holistic approach for the hospice interdisciplinary team enables members of different disciplines to
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