Volume 8, Number 29 July  17, 2019




Dear Home Care Colleague,

Note to our non-medical, patient-pay readers: Please feel free to scroll down a bit. There is news for you this week too.

The standout messages that emerged from this week's NAHC Financial Managers meeting can be summarized succinctly, but there is no watering down the urgency of the information:

  • Judging by the SRO crowds taking notes and asking questions at each keynote and breakout session with PDGM in its title, agency owners and CFOs are at best concerned, most of them nervous, at worst terrified.

  • CMS increased the so-called "behavioral adjustment" penalty from 6.42% to 8.01%, effectively canceling out the 1.5% market basket payment increase and threatening to bring many agencies to the brink of a 0%, breakeven profit margin.
    • There is still time to convince Congress that CMS is being unreasonable by guessing your future behavior and penalizing you for it in advance.
    • However, NAHC president Bill Dombi emphasized that he and his lobbyists cannot do it alone.
    • He urged every attendee in Chicago, and by extension every Medicare provider who did not make it to the meeting, to get on the phone today with their Representatives and Senators, asking them to sign on as co-sponsors to House bill 2573 or Senate bill 433.

  • The biggest difference between IPS, which destroyed 4,000 HHAs in the late 90's, and PDGM is that IPS was not required to be budget neutral. Under PDGM, CMS will continue to spend about $18 billion on the home health benefit. It will, of course, share it differently among HHAs.

  • RAP payments will shrink to 20% and eventually be eliminated. New agencies opened in 2020 will be ineligible for RAP.
    • CMS claims the change is to eliminate abuse. Dombi believes maybe as many as a dozen criminals abuse the RAP privilege.
  • While therapy visits will no longer feed the payment calculation, higher base payments will be available for wound care.

  • When the rule says some of the 432 new payment categories will subject to a variable LUPA count, from 2 to 6, it means the full episode payment kicks in at 2 or at 6, not at, for example, 3 or 7.

  • On January 1, 2020, you will have no usable historic data on which to plan your clinical approach. Data will rebuild through the year.
    • 60-day episodes will continue through the first of March until the ones opened in November and December conclude.
    • The critical period, when adjusting to a new cash flow pattern will make or break HHAs, will happen March through August.

More on this next week. While waiting, be sure to check out home care attorney Elizabeth Hogue's interpretation of a Supreme Court case that might soon lead to limiting CMS's ability to change laws merely through rule-making.

In other news: We feature two guest authors offering tips by the numbers. Tom Maxwell offers five ways for healthcare providers of all types — home health, hospice, and home care — to plan and execute a successful software implementation. Karen Frank outlines three ways to make a safer home for your patients and clients.

In our lead article, again for providers at all levels, don't miss my interview with Brightree's Nick Knowlton about Interoperability. Nick has been a board member of the CommonWell Health Network for five years and offers insights and advice pertinent to all healthcare providers. If you think interoperability is only a technical topic and only your IT department should read the interview, consider that, very soon, hospitals, ACOs, and MCOs are highly unlikely to partner with any post-acute providers incapable of sharing patient data electronically.

Have a great week. Keep making a difference! I hope to see you at Lincoln Health's Senior Care 360 event in National Harbor, MD in a couple of weeks. See below for details.

Editor signature
Tim Rowan



Brightree Executive Advocates Interoperability Standards
Brightree's Nick Knowlton has been a CommonWell Health Alliance board member for five years. Few have his insights into the movement toward interoperability.

Reigning in CMS' Authority
Guest author Elizabeth Hogue, esq., sees future SCOTUS control over CMS in a case about the enormous power wielded by regulators that frequently overrules Congress.

The 5 Things You Need to Know to Successfully Implement An EMR
Mitigate the frustration that comes with implementation and enhance post implementation buy-in by implementing your EMR correctly.

Three Ways Home Care Agencies Can Create a Safer Home
Physical therapist Karen Frank shares safety measures she and her OT husband have learned over the years as founders and owners of "Back Home Safely."

Vendor Watch
— WellSky opens new headquarters; announces inaugural WellSky Foundation recipient

 
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During the 2nd Quarter of 2019, web sites of the above advertisers were visited by home care and hospice executives and staff 2157 times.

To inquire about placing your message here, contact:

Kristin@rowanresources.com

Last Week's Most-Read Stories:
Interoperability is More Than Sharing A Little Patient Data
Experts are certain, either get on the Interoperability train or be left at the station.
(P.S. There are no patients at the station.)
 
Product Review: Innovative Therapy Technology Gets Wounded Warriors Walking Again
Gamified physical therapy system engages patients, overcomes obstacles once believed insurmountable.

As of this date, approximately 34,320,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

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.

Home Health, Home Care, Hospice GROWTH SUMMIT *

Date: Sept. 17-19
Location: Green Valley Ranch, Las Vegas

Information and Registration

Join renowned agency mentors Cheryl Peltekis and Melanie Stover for an owners' and executives' ONLY event focusing on how to survive and thrive in this rapidly changing environment. Cheryl and Melanie will break down exactly how to maximize your agency’s growth during this time of disruption in an easy to follow system you can use, over and over.

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

How to Satisfy the OIG's Requirements for Fraud and Abuse Compliance Training
Featuring: Elizabeth E. Hogue, Esq.
Date: Wednesday, August 7
Time: 1:00 - 2:30 pm EDT
Available on demand after broadcast date.
Option to purchase CD & handouts
Information and Registration
 
The OIG requires that home care providers of all types must provide effective training on fraud and abuse compliance for employees early in their employment and on at least an annual basis thereafter. Let us help you satisfy these requirements by participating in this teleconference! Whether you are a home health agency, hospice, HME company or private duty agency, gather your staff members together for this teleconference to satisfy the OIG's requirements. 
Participants will learn about three major types of fraud and abuse: false claims, kickbacks, and violations of the Stark law. Practical examples in the home care industry will be emphasized with concrete guidance about what to do about possible violations. The teleconference will also focus on how employees should raise concerns about possible fraudulent conduct internally before they even consider going outside the company. 
 


Interoperability for Service Providers through CMS’s EMDI Initiative

Presented by: ElevatingHOME and VNAA

Featuring: Pallavi Talekar, Project Manager, Scope Infotech, Inc.; Ray Wilkerson, Sr. Business Analyst, Scope Infotech, Inc.; Nandini Ganguly, Business Analyst, Scope Infotech, Inc.; Kishan Patel Business Analyst, Scope Infotech, Inc.; Briana Barnes, Project Coordinator, Scope Infotech, Inc.

Date: Tuesday, July 30
Time:
12:00 pm EDT
Fee:
Free to ElevatingHome, VNAA, and Alliance for Home Health Quality Improvement members

Registration

Representatives from the EMDI Initiative team will discuss interoperability using health IT standards, including Fast Healthcare Interoperability Resources (FHIR). Participants will learn about pilot opportunities with CMS to enhance provider workflow using three critical use cases. Participants will:
  • Gain knowledge of interoperability concepts and use of latest standards, including FHIR;
  • Gather information on three critical use cases in the post-acute care setting to reduce provider burden and enhance their interoperability footprint; and
  • Identify next steps for participation in an upcoming pilot opportunity with CMS.


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


PDGM’s Behavioral Adjustments - What You Need to Know Now

Sponsored by eSolutions

Featuring: Karri Wright, Sr. Director, Product Management at Homecare Homebase

Date: Thursday, August 29
Time: 2:00 pm CDT
Fee: Free

REGISTER NOW

The webinar covers:

  • CMS assumptions and intended adjustments and their impact on:
    • Upcoding
    • Comorbidities
    • LUPA Avoidance
  • Considerations for HHAs
  • Evaluating your HHA data now to assess tomorrow based on today’s reality


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

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