Volume 8, Number 40 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.

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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

WEBINAR: 5 Crucial Ways to Prepare for PDGM

Sponsored by: HealthCare Synergy

Featuring: Michael Tidd, LVN, COS-C, COS-D
Dates: November 13
Time:
10:00 am PST / 1:00 am EST

Information and Registration

Agencies are rapidly trying to prepare for the PDGM payment model. We will show you the most crucial ways an agency can prepare for the internal changes needed for PDGM. While most agencies are focusing on how to instruct clinicians on the change, PDGM has the most impact on office functions. Attend and gain insight on the things the agency needs to be doing now to prepare for January 1, 2020.

Objectives:
1. Learn agency level changes that can be implemented to be successful in 2020
2. Understand how to approach budgeting and finances under PDGM
3. What do your clinicians really need to know to ensure the agencies continued success

Michael Tidd has over 19 years of experience in the Home Care Industry and is a frequent speaker at HealthCare Synergy Workshops and Webinars. He is a Software Developer, LVN and Certified in ICD-9/10 Coding and OASIS (COS-C, HCS-D). As the Clinical Manager for HealthCare Synergy, he directs the Outsourced Management Services, assists in directing the development of the Healthcare Assistant Web Edition, oversees the Clinical Documentation Auditing provided to clients and directs the Clinical Form Development for the Healthcare Assistant Web Edition. Michael continues to educate agencies in the ongoing regulations that CMS produces, the proper application of the Medicare Conditions of Participation and completing timely, accurate and defendable clinical documentation to survive in the current Medicare Reimbursement Model.


Free Webinar: Your path to 99 - An Actionable Webinar on Achieving 99% Claims Reimbursement

Presented by: Complia Health

Date: November 13, 2019

Time: 1:30 PM EST

Reserve Your Webinar Seat

Billing is complex. Improving your billing and claims filing process doesn't have to be.

Getting on the path to a 99% claims acceptance rate can be simple, but the key is in understanding, and then overcoming, the common pitfalls that create problems for home health care agencies in the first place.

Join industry expert Scott Brashears to learn how to better identify potential problems in your agency processes and get the insights into solving for more accurate and timely filings that will put your agency on the path to 99.



Webinar: Post-Acute Care Quality Reporting Programs

Presented by: CMS

Date: Thursday, November 14

Time: 2:00 - 3:00 pm EST

Fee: Free

Description: The Centers for Medicare & Medicaid Services (CMS) will be hosting a webinar for Medicare-certified hospice providers to provide an overview on Hospital Quality Reporting Program (HQRP) requirements.

During this webinar, CMS subject matter experts will provide information on the following topics:

  • Hospice Item Set (HIS) reporting requirements;
  • HQRP compliance cycle;
  • How to achieve hospice compliance;
  • CAHPs survey requirements; and
  • How to switch CAHPS survey research vendors.

CMS will answer questions at the end of the webinar as time permits.

Register

Conference: 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: November 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

Conference: 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.

 


Conference: 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.

 


Seminars: 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

WEBINAR: Manage Intake Orders with WellSky + Forcura

Date: December 5
Time: 1:00 pm - 2:00 pm EST

Information and registration

Jonathan Fluhart, Intrepid USA VP of Technology & Process Excellence and Windy Adams, Forcura Director of Strategic Partnerships, will share how the WellSky and Forcura workflow solution is enabling Intrepid USA to:

  • Go 100% paperless by digitizing all faxes and eliminating manual document scanning
  • Streamline intake documentation by driving referrals, authorizations and labs to one centralized location
  • Instantly reconcile signed orders and notifications that documents are ready for approval and billing

 

WEBINAR: PDGM Preparation: Operational Strategies

Sponsored by Kornetti & Krafft Health Care Solutions & MedBridge

Date: December 5
Time: 1:00 pm EST

Information and Registration

Knowing that resources are tight as PDGM approaches, Kornetti & Krafft is offering a free overview of OASIS D1 to ensure that changes to this critical data collection instrument do not get lost in the shuffle.

What is Included:

  • Highlight key differences between OASIS D and D1
  • Make an informed decision about the use of "=" as a response
  • As an outsourced OASIS/Coding company, the most commonly seen OASIS errors and proven strategies for success will be included.

 


Seminar: "COM-CARE-CON" First Annual Technology Deep Dive

Sponsored by: Ohio Council for Home Care & Hospice

Date:
December 12
Time: 9:00 am - 5:00 pm
Location: Crown Plaza North, Columbus

Information and Registration
Com-Care-Con is a one-day conference that will highlight new technologies in the Home Care and Hospice Industries with speakers, exhibitors, and demonstrations of new technologies.

Speakers:

Tim Rowan - Keynote
Healthcare Advisory Network discussing Telehealth
Medline discussing AI in Wound Care
Complia discussing Alternative EVV

FREE WEBINAR: Quarterly Home Health Topics Discussion: The Truth about PDGM Reimbursement

Sponsored by: Healthcare Synergy

Date: December 18

Presented by: Michael Tidd, LVN, COS-C, COS-D

Information and Registration


Conference: The 17th Annual World Health Care Congress

17 Years of Empowering and Connecting Leaders in Health Care Transformation

Date: March 29-April 1, 2020
Location
: Washington, DC

Information and Registration

It’s never too soon to begin planning your experience at the 2020 World Health Care Congress. View the agenda snapshot and gain access to 100+ sessions across 15+ learning tracks:

  • Payer Transformation
  • Member Engagement and Retention
  • Provider Transformation
  • Care Delivery Integration
  • Medicaid & Health Policy
  • Behavioral Health - NEW IN 2020!
  • SDoH Business Strategy
  • SDoH Tech
  • Pop Health Analytics
  • AI & ML Applications - NEW IN 2020!
  • Innovation & Investments
  • Front Line Leadership
  • Women Leaders in Health Care
  • Self-Insurance Strategy
  • Worksite Clinics
  • Direct Contracting
  • Workplace Mental Health
  • Benefits Adviser Leadership
  • Medical Travel


*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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