Volume 8, Number 7 January  23, 2019




Dear Healthcare at Home Colleague,

After a week at sea and on a couple of Caribbean Islands, you would think I would be tanned and rested. Instead, I am more anxious and concerned than before I left. For three full days out of the 6-day, 8th Annual Compliance Cruise, I listened to attorneys and cost report consultants describe what life will be like when the new home health Medicare payment system becomes law, which will be less than 12 months from now if CMS does not postpone it. (Note to private duty providers: this week's issue is admittedly Medicare-heavy. We have one article of interest to both but we promise to regain balance between skilled and private duty next week.)

Here is the gist of what we learned. Perfect clinical documentation will become a minimum standard. Agencies that are sanctioned will be terminated instead of given opportunities to reform. Physical therapists will be in surplus; many will be willing to accept lower per-visit rates or smaller salaries just to keep a job. Change management will be the primary obligation of agency ownership and management throughout 2019. It is a Darwinian moment for all Medicare providers.

For all software users: In addition to my summary of the compliance message I heard, staff writer Darcey Trescone offers a feature article reminding agency management that internal, on-going system maintenance and appropriate utilization are the responsibility of the agency, not the tech vendor. Do you have an internal team handling this?

Again this week, there is another court decision that confuses the landscape further regarding payment denial appeals. This time, a court said your MAC can hold your money through the entire four- to five-year wait in the ALJ line. Last week a different court said the opposite. If you have appeals planned, be sure to read home care attorney Elizabeth Hogue's report on this new decision.

We are pleased to introduce guest author Laura Balcerak, an Occupational Therapist with deep experience in home health and home care and an important message to other therapists about their best course forward through the coming payment and regulatory changes. Her excellent opinion piece is titled Physical Therapy After PDGM: Thrive or Disappear?

I'll be sending next week's issue from the Homecare 100 gathering in Scottsdale. I hope to see you there. The news from the experts that Lincoln Health gathers will be of interest to both skilled and non-medical providers. We'll be sure to bring back a complete report.

Have a great week. Keep making a difference!

Editor signature
Tim Rowan



Attorneys and Consultants Agree, Start Now to Gear Up for PDGM
Between the changes that arrived with the 2019 HH PPS rule and the grand-scale changes coming next year, home health agencies would be wise to develop a change management procedure.

Physical Therapy After PDGM: Thrive or Disappear?
Guest writer Laura Balcerak, COTA, CDP, maintains an optimistic position on the fate of therapists after the next payment system removes therapy from the Home Health payment calculation.

Court Decision Threatens Rights of All Providers
Every week, it seems, another judge in another court issues an opinion contrary to last week's opinionThe following article is about a decision in which the Court refused to stop recoupments because providers lack a property interest in payments; a conclusion likely to result in severe consequences for all providers.

Agency Internal EMR Team and Accountabilities
Internal, on-going system maintenance and appropriate utilization are the responsibility of the agency...not the tech vendor. Do you have an internal team handling this?

New Version of Hospice Quality Reporting (HQRP) Quality Measure (QM) User's Manual Now Available
A new version of the HQRP QM User Manual available from CMS.

 
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Last Week's Most-Read Stories:
Is There Really No ROI?
EMR ROI requires measurement, monitoring and agency effort to be achieved.
 
Preventing Recoupment - Appeal, Appeal, Appeal!
The U.S. District Court for the Southern District of Texas ruled that CMS could not recoup monies until after Administrative Law Judge hearings have been held.

As of this date, approximately 32,395,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

PDGM National Summit in the Rockies *

Home Care Association of Colorado & NAHC


Date:
February 13, 2019
Location:
Hyatt Regency Aurora/Denver Conference Center
Fee Schedule:

Early bird – ends 11:59 p.m. MST Friday, January 11
Member $249, Non-Member $449

Regular Price  - ends 11:59 p.m. MST Sunday, February 10
Member $299, Non-Member $499 

Onsite – February 13 
Member $349, Non-Member $549

*Member rates apply to members of: Home Care Association of Colorado, National Association of Home Care & Hospice and participating state home care associations. 

Register now!

The Home Care Association of Colorado and the National Association of Home Care, together with state home-care associations in the region, will host a one-day conference Feb. 13 on the Centers for Medicare & Medicaid Services' Patient Directed Groupings Model. PDGM's adoption will bring significant change to home health care. This one-day regional conference on PDGM allows providers to hear from national experts on the new model, with significant time allocated to Q&A. Click here to view the schedule.



Information for Providers and Exhibitors


National Healthcare CNO/CMO/Informatics Summit

Date: March 18-19, 2019
Location: The Langham Huntington, Pasadena, Los Angeles, CA

The Healthcare Summits are the premium forums bringing senior level medical executives and solution providers together. The one-on-one business meetings provide access to senior medical executives within the largest healthcare organizations across the United States. A thorough selection process ensures a qualified audience, which grants unparalleled business and networking opportunities in a luxurious and stimulating environment.
Information

PDGM National Summits - Coming to a City Near You!

National Association of Home Care and Hospice

In early 2019, 12 summits were planned at strategically located cities around the United States. There are still 8 summits available to attend. Find the nearest location to gain insights and receive the tools you need to successfully transition to PDGM.  You still have time!

Previous Locations:
January 23, 2019 Orlando, Florida (Done)
January 24, 2019 Kansas City, Missouri (Done) 
February 5, 2019 New Orleans, Louisiana (Done)
February 6, 2019 Portland, Oregon (Done)
February 7, 2019 Valley Forge, Pennsylvania (Done)
February 13, 2019 Denver, Colorado (Done)

Locations Upcoming:

February 21, 2019 Columbus, Ohio

February 27, 2019 Charlotte, North Carolina

March 5, 2019 Chicago, Illinois

March 12, 2019 Boston Region - Northampton, MA (Sold Out)

March 13, 2019 Boston Region - Northampton, MA

March 19, 2019 Los Angeles, California

March 26, 2019 Dallas, Texas

Click Here for Information and to Register!

The most consequential changes to impact home health in decades are coming in 2020 — are you ready? The Patient-Driven Groupings Model (PDGM) was created by the Centers for Medicare and Medicaid Services and is slated to debut on January 1, 2020. PDGM will revolutionize the payment methodology for all Medicare Home Health Agencies (HHAs) in the United States.


2019 Omaha System International Conference: A Key to Practice, Documentation, and Information Management

Date: April 3-5, 2019
Location: Eagan, Minnesota
Fees: Pre-Conference (1 day): $165
Conference (2 days): $335
Pre-conference and Conference (all 3 days): $500

Registration and Information
The Omaha System International Conference is held every two years as a venue for those in practice, education, research, and software development to exchange experiences. There is something for everyone involved with the Omaha System, from beginners to experts to everyone in between. Joyce Sensmeier, HIMSS is the keynote speaker, and The University of Texas at Austin School of Nursing is the school host. The 2019 PDF flier includes location and registration information, speaker/planner list, agenda, exhibitors, and more.

Hospice & Palliative Care Leadership & Advocacy Conference 2019 (LAC 2019)*

National Hospice & Palliative Care Organization 

Preconference Dates: April 13-14, 2019
Main Conference Dates: April 15-17, 2019
Location: Marriott Wardman Park Hotel, Washington, DC

Rates and Fees

Register Online

Executive leadership and management at all levels of hospice and palliative care will comprise the audience for this conference, including presidents and CEOs, administrators, directors, clinical managers, finance and development professionals, quality and performance improvement professionals, regulatory and compliance officers, marketing and public relations professionals, educators, researchers and other leaders working to promote advancement of hospice and palliative care and plan its future development.


2019 Telehealth - Innovative Changes in Healthcare Delivery Conference *

Presented by: Connected Home Living

Date: April 18-19, 2019
Location: Paris Hotel - Las Vegas
Fee: $595 per person

Register

During this event, hear from some of the most dynamic and educational industry experts about current and upcoming CMS rules.  Learn about how telehealth can ease the burden of PDGM for home health, updates on PDPM for Skilled Nursing Facilities, the Physician Fee Schedule, and 2019 Quality Payment Program (QPP) for physicians.  CMS is dramatically expanding opportunities for providers to include telemedicine and telehealth in plans for improving patient care, reducing costs, and improving patient satisfaction.

 


National CXO Summit *

Presented by Marcus Evans Events


Date: May 19-21
Location: Eau Palm Beach Resort

Keynote Presenters: Susan Blumenthal, past US Assistant Surgeon General; Nicholas Webb, Healthcare Futurist

Registration Information


*The Rowan Report will see you there.

Your state or national association meeting not listed? Send the details to Conferences@RowanResources.com using this format:

Conference Title
Sponsoring Association
Date(s)
Hotel or Conference Center, City, State
URL

Navigating the Hospice Cost Report

Sponsored by: ElevatingHOME

Date: February 19, 2019
Time: 12:00pm EST
Fee: FREE

Register Now

CMS has stated that 66% of the cost reports previously filed should not have been accepted and will now be subject to more strenuous requirements. The cost reports will be used by CMS to recalibrate and adjust the hospice daily payment rates.

Join Elevating Home for this webinar as Tom Boyd, Vice President of Reimbursable Services with Simione Healthcare Consultants discusses what is new and help participants identify and understand the requirements for the completion of the Medicare Hospice cost report.



 

The Hospice Cost Report: A Requirement & A Management Tool

Presented by: Tom Boyd, MBA, CFE, CHFP, Vice President of Reimbursable Services, Simione Healthcare Consultants

Date: February 14
Time: 2:00 - 3:00 EST
Fee: FREE

Register now

Join Simione Healthcare Consultants for an overview of hospice cost reporting and ways to make sense of all the required information to support timely, accurate and affordable filing. A Simione cost report is backed by our longstanding experience with reimbursement and government reporting. Discover the difference and get the bigger picture on your hospice finances!



Learning Series Webinar: Million Hearts®2022 & Related Medicare-Covered Preventive Services 
CMS National Training Program

Date: February 14, 2019
Time: 1:00 - 2:30 EST
Fee: FREE

Register now

This webinar provides an overview of:

  • National Initiative—Million Hearts® 2022
  • Heart Disease and Stroke in the U.S.
  • Medicare-Covered Preventive Services Related to Heart Health

 



The Home Health Cost Report: Expert Advice for Hassle-Free Filing

Presented by: Tom Boyd, MBA, CFE, CHFP, Vice President of Reimbursable Services, Simione Healthcare Consultants

Date: February 21
Time: 2:00 - 3:00 EST
Fee: Free

Register now
Join Simione Healthcare Consultants for an overview of home health cost reporting and ways to make sense of all the required information to support timely, accurate and affordable filing. A Simione cost report is backed by our longstanding experience with reimbursement and government reporting. Discover the difference and get the bigger picture on your finances!

 



CMS to Test Hospice Carve-In Under Medicare Advantage
VNAA and ElevatingHOME
Date: February 20, 2019
Time:1:00pm EST
Fee: Free
Register Now 
What does this CMS demonstration mean for the hospice community? There are many unanswered questions for providers and potential relationships with Medicare Advantage (MA) plans. More than 20 million Medicare beneficiaries (34%) are enrolled in MA plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program.  
Join VNAA and ElevatingHOME Policy Consultant Jenna Paladino for an in-depth webinar to discuss the demonstration, next steps to position your program for success, and actionable items to share with your team. Now is the time to ask questions and learn how a carve-in would impact your patients. 


Webinar hosts, send your announcements to: Conferences@RowanResources.com

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