Volume 7, Number 46 December  12, 2018



Dear Healthcare at Home Colleague,

For nearly 20 years, this publication has taken the position that in-home post-acute care – including skilled home health, non-medical home care, and in-home hospice – saves public and private insurance payers more than it costs them, when total healthcare costs are included in the calculation. Still, from conference stages over the years, across microphones that always seem to be turned up just a little louder than the ones the audience uses, representatives of those payers always respond to such assertions with, "Prove it." Some claim they have data that proves the opposite.

After years of these public arguments, we were excited to read the report from a study conducted by the National Institutes of Health's National Center for Biotechnology Information. A team of physicians and statisticians followed thousands of claims for people discharged from a hospital admission after one of three common surgeries: total hip replacement, coronary bypass grafting, and colectomy. If you have ever endured an argument like the ones we have, you must read our report on this study. Click on the headline, "NIH Post-Acute Study Authors Blast CMS." In fact, you should follow the link and read the entire report. It will give you the ammunition you need the next time a payer says in-home care costs too much.

In other news: Home care attorney Elizabeth Hogue has been following the court cases that challenge CMS's right to withhold alleged overpayments during the appeals process. With a two to three year wait to bring an appeal before an Administrative Law Judge, losing contested funds in the six- or seven-figure range can be devastating. You will not believe the logic the court used in the cases Ms. Hogue explores this week. An HHA can keep the money if having CMS hold it would cause undue harm. Forcing an HHA out of business does not qualify as "undue harm." Click on "Home Health Loses Another ALJ Battle," below.

We wondered what MatrixCare will be doing now that it has been acquired by ResMed so we went to the source. Our conversation with CEO Bill Miller reveals his plans for products and how MatrixCare will prepare its customers for new Medicare payment rules. Click on our exclusive interview, below.

In October, I was invited to attend a healthcare conference hosted by Marcus Evans Events. Though the atmosphere was different from the state and national home care conferences I am used to, I was pleasantly surprised at how much I learned from executives from hospitals, rehab facilities, skilled nursing facilities, and investment banks. What was most memorable, however, was the keynote speech by former Rhode Island Congressman Patrick Kennedy. Click on "Introducing Marcus Evans Summits and Conferences" to see what I mean. The author of a number of mental health bills that he shepherded through the legislative maze to become law literally bared his soul to us while talking about his bouts with substance abuse.

Worth the trip:
New England providers (and their neighbors), put January 22-24 on your calendar. The Northeast Home Health Leadership Summit, sponsored by the state home care associations of New Jersey, New York, Massachusetts, Connecticut, Rhode Island, New Hampshire, Vermont, and Maine. The summit will be held at the Colonnade Hotel in Boston. Event website: nehomehealthsummit.com

There is still time to register for the 8th Annual Compliance Cruise. Join me, Liz Pearson, Lucian Bernard, Michael McGowan, Jim Plonsey, and Cheryl Petelkis for three days of intensive compliance consultations and presentations in the midst of a 7-day Caribbean cruise. January 13-20.

Have a great week. Keep making a difference!

 

 

Editor signature
Tim Rowan



NIH Post-Acute Study Authors Blast CMS
Researchers offer proof that post-acute care saves so much for payers that those payers should not quibble about how much post-acute care costs.

Home Health Loses Another ALJ Battle
Courts refuse to prevent CMS from recouping overpayments before ALJ hearings. Guest writer Elizabeth Hogue, Esq. has been following the effort to recover access to the Administrative Law Judge system. The latest development is not good news.

Exclusive Interview: Software CEO Looks at Post Acute Care's Future
Silver Tsunami will lead to a Silver Rush in post-acute care, says WellSky CEO Bill Miller.

Introducing Marcus Evans Summits and Conferences
Last October, former Representative Patrick Kennedy brought a group of healthcare executives to tears, then to their feet, with his courageous autobiographical keynote and appeal to concern for mental healthcare.

Ensocare and Wellpepper Streamline Patient Discharge and Engagement
Wellpepper and Ensocare join forces to improve discharge planning, post-acute placement, and patient engagement with care plans.

 
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Last Week's Most-Read Stories:
Product Review: New Mobile App Aims to Disrupt Healthcare Education Sector
Busy caregivers need education credits but rarely sit still for online courses. Startup tech company says short mobile lessons are the answer.
 
Have You Picked Your Poison Yet?
If you are in a targeted state, you get to choose pre-payment review, post-payment review, or a 25% penalty. Here is a way to learn about your choices.

As of this date, approximately 31,933,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

ICD-10 Coding: Beginner & Intermediate Workshops, Plus HCS-D Certification Exam

Presented by Home Care Association of Florida

Join HCAF and Home Health Solutions' J'non Griffin for full day ICD-10 workshops for beginner and intermediate coders, plus an optional Home Care Coding Specialist - Diagnosis certification exam!

Workshop 1: Beginner Coding
Date: March 4
Time: 8:30 am - 4:30 pm EST
Location: Four Points Miami Airport West

Beginner: Information and Registration

Overview: In this interactive class, you will learn the basics of assigning ICD-10-CM coding for home health and hospice. You will understand how it relates to billing, audits, OASIS, and compliance, and why it is so important to have accurate coding on your agency claims. You will learn the guidelines and conventions, and ethical and legal considerations. We will also teach you how to properly look up codes in your manual. Bring a current 2019 ICD-10 CM manual with you to class.

 

Workshop 2: Intermediate Coding
Date: March 5-6
Time: 8:30 am - 4:30 pm EST
Location: Four Points Miami Airport West

Intermediate: Information and Registration

Overview: This class is for the coder who understands the basics and is ready to take their coding knowledge to the next level. In this 2-day session, we will work through common home health and hospice scenarios for each chapter and discuss the rationale behind each. Understand how coding can affect accurate reimbursement, outcomes, and how important coding will be under PDGM. Understand the interaction between face-to-face documentation, clinical notes from the provider, accurate coding, and an accurate comprehensive assessment. Learn why it is important to get it right the first time. We will also discuss the latest coding clinic guidance related to coding. Bring a current 2019 ICD-10 CM manual with you to class.

 

Workshop 3: HCS-D Certification Exam
Date: March 7
Time: 8:00 am - 12:00 pm EST
Location: Four Points Miami Airport West

Download the Exam Registration Form

Overview: The Association of Home Care Coding & Compliance's (AHHC) credentialing arm, the Board of Medical Specialty Coding & Compliance (BMSC), offers professional credentials, including the only nationally accredited home health coding credential that tests coding skills exclusively, the "Home Care Coding Specialist - Diagnosis (HCS-D)." BMSC has been credentialing home health coders since 2003. More than 68% of agencies require coders to have earned the HCS-D credential as a condition of employment.


National Healthcare CNO/CMO/Informatics Summit

Presented by Marcus Evans Events

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 and registration

 


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.

National Healthcare 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 National Healthcare CXO Summit is the premium forum bringing senior level healthcare executives and solution providers together. As an invitation-only event, taking place behind closed doors, the Summit offers an intimate environment for a focused discussion of key new drivers shaping the healthcare industry.


National Healthcare CFO Summit
Sponsored by Marcus Evans

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

Register

Andrew Gwin, Senior Director of Revenue Cycle, and his colleague David Maxwell, Senior Director of Performance Excellence at Ascension, present "Denials:Improving Your Playbook." They will discuss how Clinical Denials continue to be a leading opportunity to improve net revenue for most acute hospital organizations, and how Ascension is taking a collaborative approach by developing a comprehensive Playbook that invites each hospital to take an interdisciplinary approach to improving denials.
The session will address:
  • Discuss how to develop a national best practice playbook
  • Review key components of a successful clinical denial mitigation program
  • How to implement a national best practice amongst 150+ hospitals
  • Tracking and monitoring results

NAHC Financial Managers Meeting *

July 14-16
Sheraton Grand Hotel
Chicago

Information and Registration


Senior Care 360: Strategy and Solutions Conference *

Presented by: Lincoln Healthcare Leadership

Date: July 31 - August 2
Location: Gaylord National Resort, National Harbor, MD

Information and Registration


 

3rd Interoperability Forum

Office of the National Coordinator for Health IT (ONC) 

Date: August 21-22
Location: Renaissance Hotel, Washington, DC

Register Online

This event will bring people together from ONC, the healthcare industry, and the technology sector to:
  • Learn about recent efforts to advance interoperability nationwide
  • Identify concrete actions in response to current interoperability barriers
Attendees will hear keynotes from industry influencers, have the opportunity to view demos showcasing innovative solutions and participate in tracks focused on various aspects of interoperability. Co-led by industry leaders and supported by ONC experts, the tracks will provide an opportunity to discuss the latest issues and identify actions that can be taken to address key barriers to interoperability in a group setting.
Who: Health IT standards and technology community, including developers, policymakers, technology staff at provider organizations, and consumers.

SAGE/2019 *

Hosted by Honor

Date: September 10
Location
: Portofino Hotel & Marina, Redondo Beach, CA
Time: 9:00 am - 5:00 pm

Information and Registration
(Rowan Report subscribers have been offered a 25% discount; use discount code "Rowan" when you register)

How we care for our aging population is one of the most daunting and important challenges we face as family members, as community builders, as leaders in our industry.
That’s why Honor is launching SAGE/2019, a day of inspiring keynotes, lively panel discussions, and intimate conversations on the most compelling topics in senior care and wellness. We’re bringing together thinkers and doers, innovators and entrepreneurs, academics and leaders in healthcare and home care.
You’ll meet creative thinkers who are shifting the narrative about aging, company founders who are driving change, and visionaries who are imagining what’s possible in the future. This is a unique opportunity to network with thought leaders, peers, and potential partners, to revolutionize how we think about aging, and, most importantly, to take action.

HCAOA 2019 Annual Leadership Conference *

Home Care Association of America

Date: September 22-23
Location: Marriott Tucson Starr Pass Resort

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!



Giving and Getting Referrals from Hospitals

Featuring: Elizabeth E. Hogue, Esq.

Date: Wednesday, May 8
Time: 1:00 - 2:30 pm EDT

Encore date: May 15
Option to purchase CD & handouts

Information and Registration


Referrals from hospitals may be even more important for agencies under the Medicare Program's Patient-Driven Groupings Model (PDGM). Hospitals also remain a major source of referrals for hospices and HME, amid increasing competition. Private duty agencies have a key role to play in the discharge of patients to home and referrals from hospitals are expanding rapidly. All types of providers need to know how to get more referrals from hospitals without breaking the law. And hospital discharge planners/case managers need to know the rules so the referral process remains in compliance!

This teleconference will address crucial questions for both providers and discharge planners, such as:

  • Can home care providers participate in discharge planning meetings?
  • Should home care providers have access to case managers and patients prior to discharge?
  • What do regulations and interpretive guidelines for discharge planning say about giving and getting referrals?
  • How can providers and case managers use Preferred Provider Agreements?

Extensive handouts will be provided, and there will be time for comments, questions and answers.



Understanding the Hospice PEPPER

Presented by: ElevatingHOME and VNAA

Featuring: Kimberly Hrehor, Program Director, RELI Group

Date: Tuesday, May 7
Time: 12:00 pm EDT
Fee: Free to ElevatingHome, VNAA, and Alliance for Home Health Quality Improvement members

Registration

This free webinar reviews the Hospice PEPPER—a report that summarizes Medicare claims data for individual hospices and compares their statistics to other hospices in the nation, Medicare Administrative Contractor jurisdiction, and their state. The Hospice PEPPER can be used to support hospices’ efforts to protect the Medicare Trust Fund by helping to ensure that services are correctly coded and billed, and appropriate and in accordance with Medicare Payment Policy. A new release of the Hospice PEPPER is available as of April 5. Participants will gain working knowledge of how to use their Hospice PEPPER.

Kimberly Hrehor, MHA, RHIA, CHC, PMP is a program director with the RELI Group. She currently manages a contract with the Centers for Medicare & Medicaid Services to develop, produce, and distribute comparative billing reports for a variety of healthcare providers that summarize Medicare claims data in areas that are vulnerable to improper Medicare payments. Her previous experience includes health information management, quality/performance improvement, and compliance.




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

 



Security Risk Assessment Tool Overview and User Feedback Session

Presented by: CMS

Date: Wednesday July 17

Time: 1:00 pm EDT

Fee: Free

ONC and the HHS Office for Civil Rights are holding a training session and overview of the Security Risk Assessment (SRA) Tool. The tool is designed to assist small to medium providers in conducting an internal security risk assessment. This assessment will aid providers with their security risk analysis as required by the HIPAA Security Rule and the CMS EHR Incentive program. Following the webinar, participants will have the opportunity to ask questions and provide feedback.
 
Register


"Motivating Providers to Deliver Care Vitually"

Sponsored by Arizona Telemedicine Program and Southwest Telehealth Resource Center

Presented by Jan Ground, PT MBA

Date: June 6, 2019
Time:
12:00pm MT
Fee: Free

REGISTER NOW

Learning Objectives:

1. Define the problem: be clear on the problem to be solved with telehealth initiatives.

2. Sponsorship: identify the right sponsorship, be clear on what is specifically needed from each level of sponsors.

3. Reinforcement: start with positive reinforcement, move to negative reinforcement on the clearly defined behavior changes

Jan Ground PT, MBA, has been leading clinicians and other healthcare personnel through change for more than twenty years. She led the virtual care work for the Colorado Permanente Medical Group and was the Innovation Hunter for the Colorado Region of Kaiser Permanente (KPCO). Most of her work supported innovation initiatives to enable people to get care anywhere and providers to provide care from anywhere. Areas of focus have included video visits, remote patient monitoring, e-visits, as well as the use of mobile apps and social media in care delivery. In all of these efforts, motivating providers to provide care differently was the most significant barrier to success. Jan has trained physicians and staff inside and outside of KP in Innovation, Meeting Management, and Leading People through Change. Jan has degrees in psychology, physical therapy, exercise science, and business administration from Middlebury College, Middlebury, VT; Emory University, Atlanta, GA; and the Univ of S. FL



Hospice compliance 2019: confronting a surprising new survey focus
Sponsored by: Wellsky
Featuring: Robert Markette, esq.
Date: March 14
Time: Noon CDT
Fee: None
Hospice providers today are confronting a new and unexpected survey focus. Hospice surveyors are increasingly focused on issues relating to hospice administration. This administrative focus includes topics such as your hospice’s corporate structure, the relationship between your hospice’s parent office and its multiple locations, and the role and job title of your administrator. Hospice providers who have been successfully operating for years are suddenly finding themselves hit with condition level citations. How will your hospice team adapt to the major survey focus of 2019? Join renowned hospice attorney Robert W. Markette of Hall, Render, Killian, Heath & Lyman, P.C. for an exclusive webinar that will prepare you and your team for the major survey focus of 2019.

Information and registration

Attend and learn:
Why a poorly drafted organizational chart can be a significant problem for your hospice
What hospice surveyors are looking for in the relationship between your hospice’s parent office and its multiple locations
Why calling your administrator something other than “administrator” could be a survey issue


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

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