Volume 7, Number 46 October  17, 2018




Dear Healthcare at Home Colleague,

Medicare Advantage now accounts for nearly one-third of Medicare beneficiaries and is expected to grow. More and more, certified providers will be dealing with insurance companies for payment rather than with a CMS contractor such as a MAC and an auditor such as a ZPIC or UPIC. That means they need to know how these payers operate. We have two important articles this week that should help. One is an analysis by home care attorney Elizabeth Hogue of a new OIG report that has made scathing accusations against MA companies. Another is our own commentary on Elizabeth's analysis, from the point of view of a Medicare beneficiary and taxpayer. You'll want to read both, so click below, first on "What Providers Should Do About Denials From Medicare Advantage Plans" and then read "A Patient and Taxpayer Looks at the OIG MAO Report."

Other news this week: Keeping an eye on tech vendors for you, we report on a new release by Brightree in the Home Medical Equipment sector, and a partnership of note by e-Caregiving that will enhance patient engagement and family caregiver support. Regular readers will remember that we profiled e-Caregiving a couple of weeks ago in "Experts Release Software for Staff Retention/Recruiting; Training Family Caregivers." Longtime home care nurse Tina Marrelli saw a need, family caregiver burnout, and found a creative way to address it.

Private Duty agency owners will want to watch this space next week. We have been researching the resurrection of Honor Health, the San Francisco startup that famously failed with its attempt over the last two years to "uberize" home care. Their second attempt to find the best use of the technology they developed is to partner with small- to medium-sized non-medical agencies. We have heard pros and cons and have spoken with early adopters and with Honor president Nita Sommers. We'll tell you what we think next week.

Compliance, compliance, compliance
Anybody old enough to remember Frankie Ford? I've had his 1959 hit on my mind lately. "Come and let me take you on a Sea Cruise..." In January, I will be joining a host of other consultants and attorneys on the 8th annual Compliance Cruise and I encourage you to consider it. Three solid days of rules and regulations and how to follow them to keep your agency safe from payment denials and accusations of fraud, all from presenters who know the regs better than anyone. Between those three days, get away from winter on the Royal Princess, with several stops in the Caribbean. What is more, all of the experts are available the entire week for consultations, and the policy of the organizers, Pearson & Bernard Law, is that they are not allowed to charge you for their consulting while on the ship. Take a look at the brochure here.

I am on my way to address the good people of the New York State Home Care Providers association next week in Uniondale. I look forward to seeing my great New York friends there.

Have a great week. Keep making a difference!

Editor signature
Tim Rowan



What Providers Should Do About Denials From Medicare Advantage Plans
Guest author Elizabeth Hogue, Esq. looks at the OIG report on abusive insurance practices and finds the familiar refrain "always appeal" applies to Medicare Advantage plans as well as Medicare MACs and UPICs.

A Patient and Taxpayer Looks at the OIG MAO Report
Editor Tim Rowan takes a deeper dive into the OIG report on Medicare Advantage Organization abuses.

ICmed and e-Caregiving Partner
Medicare estimates 66 million lay caregivers in the US. New partnership formed to bolster patient-caregiver engagement.

Brightree Releases "Patient Hub" for HME Providers
App to enhance patient communication introduced at Medtrade conference.



During the 4th Quarter of 2020, web sites of the above advertisers were visited by home care and hospice executives and staff 4319 times.

To inquire about placing your message here, contact:

Kristin@rowanresources.com

As of this date, approximately 31,317,000 Baby Boomers have become Medicare eligible.

 

Last Week's Most-Read Stories:

Software Company Fined $115 Million
Could it happen in post acute care?

Telehealth Giants MIA but RPM Startups Make A Splash at NAHC Conference
In spite of some surprising absences, remote patient monitoring was a strong theme at this year's NAHC Conference and Expo.


Upcoming Events

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.


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:

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

Register

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.

 


WEBINAR: Key Documentation Issues for 2020 & the Future

A 90-Minute Lunch & Learn Audio Conference by Elizabeth E. Hogue, Esq. Health Care Attorney

Date: March 18
Time:
1:00 - 2:30 EDT

Encore date:
March 25; On-demand recording available


Information and Registration

Documentation remains a key requirement for home care providers as the consequences for inadequate documentation become more severe.

Gather your staff members to emphasize effective documentation yet again. Real examples of cases involving problematic documentation will be presented. Questions and case examples are welcome, and extensive handouts will be provided for use by staff members.

Recordings Available: Pandemic Recovery - Rebuild Stronger Than Ever

Texas Association for Home Care and Hospice

Two days of keynote and breakout presentations for home health and hospice providers.

Purchase Recordings

 


Webinar Series: Sales Training, Home Health and Hospice

Presented by: Healthcare Strategica, LLC

Featuring: Michael Ferris

1 - 8-week Hospice & Palliative Care Sales Training Course

2 - 8-week Home Health Sales Training

Rowan Report subscribers: Register with this link to receive $100 discount.

We have taken our best of class industry specific sales training bootcamps and are offering them via Webinar to enable you to continue to train your sales team in today's world of limited travel and social distancing.

The Hospice and Palliative Care course will be offered live every Tuesday starting May 19 through July 7, 2020.

The Home Health course will be offered live every Tuesday starting May 21 through July 9, 2020.

Each class will have participation exercises, homework assignments, quizzes and question and answer opportunities.

Each participant will receive their own course materials and individual coaching and feedback. At the conclusion of the course each student will receive a certificate of completion, an invitation to join the exclusive Sales Mastery Group* and opportunity to join the 52-week Sales Training Excellence Course.*

* Only available to Sales Professionals that have successfully completed the 8-week Sales Training Course – additional fees may apply.

Each session will be offered on-demand and if unable to attend the live webinar, you will be able to view the recording and participate in exercises, questions, coaching and quizzes. If you start after the first webinar date, you will be provided with access to those classes missed so that you can get caught up or you may elect to attend via the recorded sessions.


FREE WEBINAR: How Technology Enhances Home Care in an Increasingly Remote World *

Sponsored by: Care Connect

Moderator: Tim Rowan

Panelists: Mike Gelman, President COO, CareConnect; Jim Rolla, SVP, VNSYNY Partners in Care; Steve Pellito, SVP, Provider Sales, Sandata

Date: November 12
Time:
1:00 pm EDT

Register


The 2021 Home Health Final Rule 

Insights to position your agency for success

Sponsored by: WellSky

Featuring: Sharon Harder, president, C3 Advisors; Jill Dyer, BSN, RN, HCS-D, HCS-O, president, JID Consulting and Coding, LLC

Date: November 18
Time: 1:00 - 2:00 EST

Attendees will learn:

  • How to prepare for and implement the operational changes imposed by the final rule, including submission of no-pay RAPs within five calendar days of the start of care and changes to the types of non-physician practitioners who can order home health services
  • The impact of CMS’s decision to retain the PDGM behavioral adjustment
  • The status of proposed legislation aimed to allow home health agencies to bill for telehealth services during public health emergencies and how this change would affect care planning and delivery

FREE WEBINAR: Cybersecurity in Healthcare: Assess Threats & Reduce Your Risk

Presented by: Netsmart

Featuring: Randy Pargman, Binary Defense senior director of threat hunting and counterintelligence; Sharon Hicks, MBA, MSW, OPEN MINDS senior associate; and Mike Murray, Netsmart director of Plexus Technologies,

Date: December 9

Time: 1:00 EST

Information and Registration

Healthcare organizations are often at risk of cyberattacks due to a lack of dedicated IT and reliance on traditional reactive approaches. To learn how to protect your data, register now to join Randy Pargman, as they map the risk landscape and provide guidance for safeguarding your organization.

Key takeaways:

• Cyber threats in healthcare
• Impacts of a data breach
• Best practices for securing your data


 

FREE WEBINAR: Can you collect Cash faster?

Sponsored by: Savii

Date: Tuesday, January 12

Time: 2:00 pm EST

Information and Registration

With small margins in home care it has prompted the question, “Can we collect cash faster?” And what would this do for an agency? One thing we know is margins are small and have become more challenging than ever to for agencies to profit. This doesn’t mean it impossible for agencies to survive; it means a focus on collecting cash faster will be ever so important.


Agency leaders will first need to develop a timeline cadence of when to address claims based on when they were submitted for payment. In addition it will be pertinent to understand their own agency metrics such as DSO (Daily Sales Outstanding) and how they compare to industry standards.

On this webinar you will walk away with how to develop a timeline and your own DSO dashboard for benchmarking. All of these topics will weave into  strategic steps to take toward collecting cash flow faster.

FREE WEBINAR: Return to Work under COVID-19

Presented by: Healthcare Synergy
Featuring:
David Mauzey, SVP & General Manager, HealthPointe Solutions

Date: January 14
Time: 11:00 - 11:30 PST

Register

The COVID pandemic has evolved, initial processes in place ensure a safe work force environments but need to evolve to stay effective and efficient. Home health has an extra layer of scrutiny given the population may be at a higher risk. This webinar will focus on how an organization can evolve to keep their workforce and patients safe. HealthPointe Solutions has a full inventory of new and advanced recommendations that help implement and maintain site safety. This includes step-by-step guidance that include medical testing administration strategies, patient/employee monitoring, training/education and program auditing.
Objectives:
David Mauzey has over 25 years' experience in healthcare, helping bring operational efficiency solutions to both providers and payers. Within HealthPointe Solutions, he is responsible for operations and was a part of the team that developed HealthPointe Solutions’ COVID response solutions. Prior to joining HealthPointe Solutions, David served as VP and GM of Optum's Network Payment Innovation, where he focused on alternative payment programs, including bundle d payments and population-centric, value-based programs.

FREE WEBINAR: The Rise of Hospital at Home: A Roundtable Discussion

Sponsored by: AlayaCare

Featuring: Dr. Bruce Leff, Hospital at Home Pioneer & Professor, John Hopkins School of Medicine; Adrian Schauer, Founder and CEO
AlayaCare; Joel Theisen, Founder and CEO, Lifesprk; Brady Murphy, VP Sales & Marketing, AlayaCare

Date: Wednesday, January 27
Time:
1:00 EST

Information and Registration

Agenda
Across the U.S., the Acute Hospital Care at Home initiative from CMS is taking off amid the pandemic with at least 80 approved participants to date. As hospital-at-home models become more popular and more beneficial to both patients and health care organizations, those that have recognized the perks of home-based care prior to the COVID-19 crisis may have the upper hand.

Join us on Wednesday, Jan 27th at 1:00 pm EST for a roundtable discussion with industry experts such as Dr. Bruce Leff, Hospital at Home Pioneer and Professor at John Hopkins School of Medicine who deserves his reputation as a founding father of this virtual hospital concept, to learn about the hospital-at-home model and its impact on the home care industry.



FREE WEBINAR: 5 Key Elements of a Successful Home Health Remote Patient Monitoring Program

Presented by: Amity Healthcare Group

Featuring: Irina Gorovaya, owner and president of Amity Healthcare Group; Erin Vallier, AlayaCare Account Executive; Kaila Raimondo, AlayaCare Solution Engineer

Date: Wednesday, January 27

Time: 2:00 pm EST

Information and Registration

 

Agenda:

Explore key factors and solutions necessary for successful deployment of patient remote monitoring program in home health.

The discussion will include policies and procedures, documentation, staff education, and telehealth equipment and solutions.


FREE WEBINAR: Rubber Meets the Road with the No-Pay RAP

Sponsored by: KanTime & BlackTree Consulting

Featuring: Nick Seabrook, Managing Principal and Founder, BlackTree; Kim Spence, RN, Director, KanTime Customer Success; Greg Lotz, Director, KanTime Marketing & Sales Technology

Date: February 4
Time: 2:00 EST

Register

AGENDA:

Re-visit regulatory changes and how they have impacted agencies. Plus, tips and tricks to stay ahead of the curve.


Virtual Conference: Winter Leadership Summit

Presented by: National Association for Home Care and Hospice

Date: February 23, 2021

Register


Homecare 100 *

Presented by: Lincoln Healthcare Leadership

Date: June 27-30, 2021
Venue: JW Marriott Marco Island Beach Resort, FL

https://www.homecare100.com/


*The Rowan Report will see you there.

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!



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:


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:

 



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:



OASIS-D: Ensuring Consistency & Accuracy

Presented by Curaport
Featuring:
Melissa Abbott, RN, MSN, MHA, of 5 Star Consultants

Date: Thursday, October 18
Time: 2:00 p.m. EDT

Fee: $99 (per attendee)

Information & Registration

* This education session is approved for one (1) contact hour of Continuing Education for Nursing.

OASIS! Possibly the most spoken word, or acronym, in the Home Health industry. And just when you get to grips with the current version, the next set of changes arrive before you know it, this time in the form of OASIS-D. In this webinar, you will gain an understanding of the significant changes D brings to OASIS and how to ensure consistencies and accuracy within your agency.

 

*Curaport, LLC is an approved provider of Continuing Education by the California Board of Registered Nursing. All states accept this certification for their licensing requirements. No refund shall be given, except for any change in date or time of the webinar. In such case, a full refund shall be given to the registrant upon request.



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



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



Your state or national association meeting or webinar 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



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