Volume 8, Number 18 April  24, 2019



Dear Healthcare at Home Colleague,

I got to meet some interesting people at last week's "2019 Telehealth" conference in Las Vegas, sponsored by Connected Home Living. In addition to Bill Dombi's detailed explanation of upcoming PDGM rules and how he expects Medicare providers to adjust, I met Elcee Cortez, BNS, RN, the president of the Philippine Nurses' Association, a wonderful nurse and wonderful organization dedicated to patient care. And I met retired DEA agent David Schiller.

If you are a regular "60 Minutes" viewer, you may recognize Schiller's name. Rather than go into detail here, I'll let you read my interview with him in this week's issue. You need to read it if your field staff has ever been in a home where there are leftover opioids or other controlled substances. According to Schiller, that is just about every person on your staff. A new law authorizes hospices to dispose of these drugs but every caregiver who enters a home should be aware that leftover dangerous meds are probably there. He related one story about a woman who showed up at one of his disposal centers with two lawn leaf bags full of prescription bottles.

In my interview, you will learn your legal obligations and a new way to handle no longer needed controlled substances when you find them. See "New Product Solves Leftover Controlled Substance Problem."

Another Chapter in the Ongoing ALJ Controversy
Guest author Elizabeth Hogue, esq. continues her series tracking court cases trying to settle the issue of who gets to hold the money, you or your MAC, during the appeals process. In recent months, she has told us about several cases but they were all decided differently. Sometimes CMS wins, sometimes the provider, depending on the judge's opinion. When CMS wins, however, the provider often goes out of business while waiting its turn in front of the ALJ. That is what happened in the case Hogue tells us about today. Except this time, the owner of the destroyed home health agency filed a class action suit, claiming the devastating extrapolation was founded on UPIC or ZPIC misunderstanding of its own rules. The stakes are getting higher and higher, Hogue warns. Be prepared.

In other news, be sure to see this week's Vendor Watch column for announcements of two partnerships. Casamba has started working with Forcura, and Netsmart has a new partnership with Senior Living provider Plum Healthcare. Hospice providers will be interested to read about a gentleman who became frustrated with the wrong kinds of chairs and beds provided to people at end of life. So he invented his own. The Immersus Health Company was founded to set a new standard with clinically proven products designed specifically for hospice patients.

Speaking of hospice, be sure to scroll down to read about a free webinar offered by ElevatingHome and the VNAA, "Understanding the Hospice PEPPER."

Worth the Trip
Association conference season is upon us and we will be attending a few state meetings next month. Senior staff reporter Darcey Trescone is at the Missouri association meeting this week. I will be speaking at the annual meeting of the New York State Home Care Association in Saratoga Springs on May 9-10. After that, I'll be going straight to the Rockies for the Colorado association meeting on May 15-17. I hope to see you at one of these events.

Have a great week. Keep making a difference!

Editor signature
Tim Rowan



Providers v. UPICs and ZPICs: Another Chapter
Guest author Elizabeth Hogue brings us another chapter in the continuing saga of Providers v. UPICs and ZPICs. The stakes are high! Providers must continue to seek relief from the courts from devastating actions by the UPICs and ZPICs.

New Product Solves Leftover Controlled Substance Problem for Hospices
What do you do with leftover opioids after a hospice patient dies? Rules from the DEA and EPA make it clear you have only two options, and one of them can be expensive. Here is our review of a new product for the other option.

Immersus Health: Clinically Proven Products for Hospice
Patients at the end of their life deserve exceptional care and appropriate products. The Immersus Health Company was founded to set a new standard with clinically proven products designed specifically for hospice patients.

Vendor Watch
— Plum Healthcare and Netsmart partner to enhance integrated care in senior living
— Casamba partners with Forcura for document workflow solution, aimed at streamlining documentation.


 
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During the 1st Quarter of 2019, web sites of the above advertisers were visited by home care and hospice executives and staff 2026 times.

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Kristin@rowanresources.com

Last Week's Most-Read Stories:
EMR Vendors Discuss PDGM Preparations and Innovations
The success of your transition to a drastically different Medicare payment system is largely dependent on the efforts of your EMR vendor. Staff writer Darcey Trescone spoke with three more of them this week to learn what they are planning for you.
 
Medicare Trims Payments To 800 Hospitals, Citing Patient Safety Incidents
We republish a story from Kaiser Health News as a reminder to be grateful that some healthcare segments have problems we do not have.

As of this date, approximately 33,396,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

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

WEDI Spring Conference

Presented by: Workgroup for Electronic Data Interchange

Date: May 20-22
Location: Hyatt Regency La Jolla at Aventine, San Diego

Information and Registration

Serving as a private and public industry solution to critical healthcare problems, WEDI is a coalition comprised of a cross-section of the healthcare industry: doctors, hospitals, health plans, laboratories, pharmacies, clearinghouses, dentists, vendors, government regulators and other industry stakeholders.

Agenda will include the following sessions:
- The Imperatives for Interoperability Standards in the Future of Healthcare and Plecosystem Economy
- The Changing Dynamic in Healthcare Security: The risk or the promise?
- Understanding the Models, Transactions, and Data Flows of Encounter Data Reporting
- Best Practices for EFT Enrollment Security
- Provider Adjustments (PLB) in the Electronic Remittance Advice (835) – How do they work?
- Anatomy of Value-Based Payment: An Interactive Discussion
- Barriers to the Broader Adoption of Telehealth

 


*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

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.




How to Drive Hospice Growth: New Strategies and Opportunities

Presented by: Netsmart
Featuring: Lisa Lapin, Simione Principal; Wayne Regan, Simione Director; Stacie Stark, Netsmart

Date: Thursday, May 30
Time: 2:00 pm EDT
Fee:
Free

Register Now

Have you identified new growth opportunities for your hospice agency? Do you have solid referral management strategies in place? Join us as Simione Principal Lisa Lapin and Director Wayne Regan discuss how to perform a market analysis and needs assessment so you can discover potential growth opportunities. Stacie Stark, director of client engagement with Netsmart, will explain how you can develop referral management strategies to grow your business. At the end of the webinar, you will be able to:

  • Describe growth opportunities in the hospice market
  • Identify steps to perform a market analysis and needs assessment
  • Define the key elements of an integrated marketing plan
  • Identify ways to work with data to enter new markets


The ABCs of PDGM: What it Means to Home Health and How You Should Prepare
Hosted and presented by: HEALTHCAREfirst 
Date:  May 16, 2019
Time: 1:00pm CT
Fee: Free

REGISTER NOW

According to industry experts, the Patient-Driven Groupings Model (PDGM) is the biggest change to home health in nearly 20 years. HHAs of all shapes and sizes can expect significant changes for episodes beginning on or after January 1, 2020. You must have a deep understanding of how PDGM works and how it will affect your reimbursement to successfully prepare well in advance of this change. Join HEALTHCAREfirst’s regulatory team for an overview of PDGM, including tips and resources to help your home health agency prepare.

We’ll share with you:

  • Overview of PDGM
  • PDGM Basics including 30-day Payment Periods and Case-Mix Components
  • Documentation, billing, and reimbursement changes
  • Best practices to help get your agency ready


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

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