Volume 8, Number 34 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 3rd Quarter of 2019, web sites of the above advertisers were visited by home care and hospice executives and staff 2767 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

 

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.

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


Fall Conference: ICD-10 & Emergency Preparedness

Texas Association for Home Care & Hospice

Date: October 9
Venue: Great Wolf Lodge
City: Grapevine, TX

Information and registration


NAHC 2019 Conference & Expo - Foresight: Care for the Future*

Join NAHC and hundreds of your peers to explore the pioneering spirit of home care and hospice providers!

Date: October 13-15
Location: Seattle, Washington

Information and Registration

Join us in Seattle, Washington, this October as the National Association for Home Care & Hospice explores “Foresight: Care for the Future.” Explorers are leaders and risk takers. They have a vision for the future, and they help others see and believe their vision. Our role as pioneers and explorers is to help others understand that home care and hospice are “Care for the Future.”

Our educational sessions have been completely redesigned with you in mind, and there’s something for everyone! Choose from over 80 sessions that cover topics that most concern you and your business.

Hear from top experts on:

  • Effective strategies to prepare for the implementation of the Patient-Driven Groupings Model (PDGM), which begins on January 1, 2020
  • Home care and hospice regulatory changes, including quality, finance, and compliance topics
  • Innovations in palliative care and hospice, including technology, quality assurance and business development
  • Trends in care continuum management and the development of relationships to facilitate care
  • Growth and development of staff, beginning with talent acquisition
  • Business and workforce development, leadership, and financial management for private duty and private pay organizations

These sessions will leave you informed and excited to implement new ideas in your workplace.

Pre-conferences will offer a more focused exploration into key topics

  • H3IT: International Conference on Home Healthcare, Hospice, and Information Technology
  • PDGM Summit: An In-Depth Primer
  • NAHC Grassroots Advocacy Boot Camp

 


Two Sales Training Boot Camps: Home Health and Hospice & Palliative Care

Presented by Healthcare Strategica, LLC

Featuring: Michael Ferris
Location: Westin Lake Las Vegas Resort

Bootcamp 1: PDGM Home Health Sales
Date: November 12-13

Bootcamp 2: Hospice & Palliative Care Sales
Date: Novenber 14-15


Register with code "HCTR" for $100 off.

Michael Ferris brings 20+ years of experience to your sales team!

Home Health Sales Training Bootcamp

The Home Health Sales Training Bootcamp has an extensive training related to Success Under PDGM.  We will cover what the Sales Professionals need to know about PDGM and more importantly what the referral partners need to know!  How to have those conversations to drive more referrals and avoid the pitfalls experienced by hospices when "failure to thrive" was no longer an acceptable primary diagnosis to qualify for hospice services.

Hospice Sales Training Bootcamp

The Hospice and Palliative Care Sales Training Bootcamp is new and improved with the best of class sales training for hospice with the addition of How to Conduct Family / Patient Meetings for Maximum Success and How to Sell Palliative Care.  Send your Hospice Sales Representatives to us and we will send them back to you ready to drive significant incremental growth in quality admissions.

Each Sales Professional Will Receive:

  • Class Workbook
  • Laminated Field Cards
  • Copy of Definitive Guide to Home Health Sales: Achieve Superstar Success - PDGM Success Edition ($79 value)
  • One on one coaching
  • 90-day sales campaign planning tool
  • Lunch each day

Successful Home Health Transformation

Hosted Dixon Healthcare Solutions, Inc.

Date: December 5-6
Location
: Bally's, Las Vegas
Time: 7:00 am - 4:00 pm
Speakers: Richard K. Dixon, Cheryl Peltekis, RN, Meaghan McCormick, Esq., Donna Floyd, RN, BSN, J'non Griffin, RN, MHA, HCS-D, BCCH-C, COS-C, WCC; Annette Lee, RN, MS, HCS-D, COS-C; Cory Mertz, managing partner for a leading healthcare M&A firm.

Information and Registration

Approved for up to 10 hours of Continuing Nursing Education by Corexcel, an accredited provider by the American Nurses Credentialing Center's Commission on Accreditation.

 


Successful Hospice Transformation

Hosted Dixon Healthcare Solutions, Inc.

Date: December 5-6
Location
: Bally's, Las Vegas
Time: 7:00 am - 4:00 pm
Speakers: Richard K. Dixon, Cheryl Peltekis, RN, Meaghan McCormick, Esq., Donna Floyd, RN, BSN, Annette Lee, RN, MS, HCS-D, COS-C; Cory Mertz, managing partner for a leading healthcare M&A firm.

Information and Registration

Approved for up to 10 hours of Continuing Nursing Education by Corexcel, an accredited provider by the American Nurses Credentialing Center's Commission on Accreditation.

 


PDGM Success Seminars hosted by Axxess *
Sponsored by: BKD, Aegis Therapies, HealthCare ConsultLink, Home Health Care News, Gateway Home Health Coding and Consulting, Worldview, Connected Home Living, Laengrich Healthcare Partners and Swift Medical

Dates and Locations (open to all Home Care providers):
  • Dallas, TX Tuesday, September 24
  • Houston, TX Thursday, September 26
  • Boston, MA Tuesday, November 5
  • Fort Lauderdale, FL Thursday, November 14
  • Chicago, IL Tuesday, October 22
  • Columbus, OH Thursday, November 12
  • Las Vegas, NV Friday, October 4
  • McAllen, TX Tuesday, December 3
  • San Antonio, TX Thursday, December 5
Information and Registration (early bird discount code: Axxess2020)
The one-day seminars will focus on the following learning objectives:
  • The PDGM impact numbers that matter most, along with operational strategies to ensure proper reimbursement                   
  • Specific actions to take for each PDGM risk factor, including coding, non-groupable diagnoses, LUPA avoidance and management, chronic care management, and therapy management
  • How to drive growth for your organization through institutional referral strategies and the use of specialty programs, including wound care and complex nursing
Including specifics such as:
  • How to get the most important OASIS information you need in five minutes
  • Implementing maintenance therapy programs and telemonitoring
  • Setting up visit schedules that prevent avoidable LUPAs 
  • How each component of PDGM builds the case weight 
  • Restructuring intake processes to obtain necessary billing 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

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


A QUALITY JOB: Clinical Management & Care Coordination Under PDGM

Hosted by VNAA
Sponsored by MatrixCare/Brightree
Presented by Simione Healthcare Consultants

Featuring: Laura Wilson, RN, BSN, Sr. Manager, Simione Healthcare Consultants
Date: Wednesday, September 11
Time: 12:00 pm EDT

Free Registration

PDGM is so much more than a billing change! Home health agencies preparing for payment reform need to look closely at clinical operations to make accommodations that will uphold quality, including care alternatives that add value to the equation. In this webinar, we’ll share insights based on the findings of gap analyses to help your organization make a successful transition under the new requirements. Recommended Attendees: Clinical Managers, Intake Staff, Coders / QA, Finance & Billing personnel Hosted by VNAA, sponsored by MatrixCare/Brightree, presented by Simione Healthcare Consultants



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

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