Creating Value Based Home Health Programs for Improved Outcomes
|
|
- Jocelyn Palmer
- 5 years ago
- Views:
Transcription
1 Creating Value Based Home Health Programs for Improved Outcomes HHSM Executive Clinical Director Melissa Couty BSN HH National Clinical Director HHSM Progressive HH Clinical/Operations Firm Founded by Arnie Cisneros Post-Acute >30 yrs SURCH - UR Protocol - nationally for HH Providers Daily HH POC development and management HHSM UR Pioneer ACO PAC Med Adv Auth Bundled Payment for Care Improvement (BPCI) HHGM Clin Management Model Unique to HH Post Acute PPS 30 Day PAC Bundling (2021) Healthcare Reform Arrives in Terms of Value (versus Volume) Programming 1
2 Home Health Value Programming Changes Fiscal Results tied to care quality performance Increased attention to Care Intrinsics required Traditional Care Approaches now defunct Clinician i i Managed care WON T WORK Focus Independence, Acuity, Compliance Increased Reporting, Communication Lacking HH Utilization Decreased Payments Home Health Value Programming Changes Management of Nursing/Rehab Volumes Safety Based Clinical Frequencies Provider Control of Scheduling/Productivity Programs change due to in episode progress MD care management altered to Value goals Care volumes altered due to acuity identity Care delivery & value changes = STRESS Why Value Programming Works for the Home Health of Tomorrow 2
3 Why Value Programming Works for Home Health Improves Care Quality/Results for CMS beneficiaries Offers a quality HH response to Reforms and Cuts Assures Optimal Payment and Quality HH Outcomes Directly addresses Star Ratings Quality concerns Resolves CMS Reform Focus ER visits, Readmits Manages care on an IN-AGENCY basis SOC to DC Rewires Volume model for front-line clinical staff Care platform for future Value Models (PAC PPS) Utilization Review Management of Home Health for Value Outcomes (Volume to Value Shift) Utilization Review Management of Home Health Creates episode expectations and specific care plans for programming based on QA identified clinical concerns or deficits. A refined clinical profile is employed to create an individualized patient program modified in an ongoing manner through In Episode Management for response to treatment, clinical efficiency, skill management, required documentation, and rapid value outcomes. 3
4 Relation of Clinical to Fiscal Factors in Home Health Programming Model Review of HH PPS Model for Clinical & Fiscal Identity HH 60 Day Certification Period up to 60 days of care Acuity based Case Mix creates Cost based HHRG rate OASIS Admission Assessment cornerstone of HH PPS OASIS Multi System/Discipline global assessment HH POC reflective of OASIS clinical profile declines HH Clinical disciplines Evals Objective POC Program Skilled HH Episode thru CMS required HH content Episode DC or Recertify Goals met or Another 60 Days Home Health PPS Clinical vs. Fiscal Analysis HH PPS incorporates both CLINICAL &FISCAL elements Clinical Factor is the primary driver in HHRG care model Clinical component is based on patient acuity level Patient acuity established via accurate OASIS admit Clinical Acuity connects to Fiscal Identity (HHRG) Clinical acuity & Therapy volume determine CMI HHRG Higher Acuity patients = Higher Case Mix & HHRG rate Relates to value of accurate OASIS SOC data 4
5 How Volume Approach & Operational Inefficiencies relate to Value-Based Programs How Volume & In-Efficiency affect Home Health Value Volume 60 Day Cert Period approach Post Acute Care Volume Lack of timely interventions SOC, Evals, Visits Volume Lack of Global Program, clinical schedule model Volume Lack of Safety Based frequency limits acuity Inefficiency Inaccurate OASIS, Admit POC development In Efficiency Decreased content focus audit issues In Efficiency Lack of content increases volume to goals In Efficiency Lack of DC Control leaves uncovered care How Clinical ID Affects Case Mix in Home Health PPS Model 5
6 Clinical Factors affecting Home Health Case Mix HH PPS is based primarily on patient clinical identity OASIS admission document determines patient specifics OASIS has been challenge for Home Health since intro Timely admission, struggle for accuracy, INTERVIEW OASIS accuracy rates = 70% despite ongoing education Inaccurate OASIS ADL profile both nursing & rehab OASIS DC more accurate than Admit we learn patients Lack of Global programs Multi System/Discipline SOC Operational Areas in Home Health Model that Compromise Clinical Acuity Home Health Operational Areas affecting Acuity ID Intake Integrity Incomplete intake data limits timely SOC OASIS Admit Inaccurate Case Mix clinical data profile POC Development Inaccurate OASIS data, non global Scheduling Control Managed by front line staff, MV Documentation Review Unqualified Evals, Visit notes In Episode Management Assures rapid, skilled progress Rapid Outcomes Timely goal resolution vs. increased LOS Discharge for Outcomes Independent DCs, dovetail DC 6
7 Management of Home Health Operational lareas for Value Results Home Health Operational Management for Value Intake Scripting for complete referral for 24 hour SOC OASIS Collaborative SOC Accurate profile, functional walk POC Development Global POC (30 day) by decline depth Add on Disciplines 48 hour addn disciplines, connect to SOC Scheduling Control Safety Based Frequencies MV mgmt Documentation Review Unqualified Evals, routine visit notes In Episode Management Weekly clinical rounds Rx to date Discharge for Outcomes Rapid outcomes, Post DC HP Fiscal Results of Value Based Home Health Episode 7
8 Fiscal Results of Value Based HH Episode $150 Accurate and evolved OASIS SOC data (5%) $600 POC control Nursing & rehab visit totals (22%) $200 Ongoing real time schedule control, loss of MV (7%) ($??) IEMs assure skill, Patient/Cgvr status, desired goals (4.5 5 Star) Assures Value Based Purchasing bonus Fiscal results from Utilization Review versus Traditional HH Total Bottom Line HH Savings >30% versus HHRG benchmark Addresses HH reforms, ACO mgmnt, HHGM, Post Acute PPS Summary of Operational Approach to Value Based Home Health Care Operational Summary re Value Based HH Care HH Volume legacy hampers program value and outcomes Burden Over reliance on Volume Structure of HH PPS model Demos value of Clinical Acuity Management for HH success SOC & Eval accuracy, Efficient SOC DC operational mgmt HH Reforms address value in operations/payment structure Increase Clinical & Operational value, decrease volume Reforms require Utilization Control for value model install Rewire HH agency in value terms for HHGM, VBP, PAC PPS 8
9 Home Health Strategic Management HHSM 9
Unlock the keys to success in the future: Clinical targets for care programming control
MISSOURI ALLIANCE HOME CARE (MAHC) Unlock the keys to success in the future: Clinical targets for care programming control Kimberly McCormick RN/BSN 22 year Home Health Clinician 22 years in Home Health
More informationValue - Based Purchasing (VBP) Comes to Homecare How Can You Prepare? HealthWare
Value - Based Purchasing (VBP) Comes to Homecare How Can You Prepare? HealthWare Arnie Cisneros, P.T. HHSM 30 years Medicare Care Continuum 30 year Home Health clinician/consultant Progressive rehab clinical
More informationPPS Therapy. Medicare 2/28/ year Home Health clinician/contractor. 30 years Geriatric Rehab. Home Health consultant, author, speaker
PPS Therapy Changes 30 year Home Health clinician/contractor 30 years Geriatric Rehab Home Health consultant, author, speaker Progressive programming/clinical delivery Progressive management systems Home
More informationValue Based Care in LTC: The Quality Connection- Phase 2
Value Based Care in LTC: The Quality Connection- Phase 2 Joseph J. Tomaino, M.S., R.N., Principal Healthcare Transformation Consulting ChemRx/PharmMerica Geriatric Skilled Nursing Seminar December 7, 2017
More informationGet A Seat at the Table
Get A Seat at the Table Develop Cross-Continuum Networks in the Competitive, Performance-Driven Senior Living Industry Hilary Forman, PT, RAC-CT Senior VP, Clinical Strategies Division, HealthPRO Heritage
More informationHealthcare Leadership Council: John Perticone Golden Living 3/9/2016
Healthcare Leadership Council: Care Transitions in Post Acute Care John Perticone Golden Living 3/9/2016 Golden Living Profile Golden Living Centers and Communities 296 skilled nursing facilities 15 assisted
More informationCY 2018 Home Health PPS Proposed Rule
CY 2018 Home Health PPS Proposed Rule Rochelle Archuleta & Caitlin Gillooley AHA Policy August 24, 2017 CY 2018 Proposed Rule Published in July 28 Federal Register Net Reduction: 0.4%, -$80m Same for facility-based
More information8/28/2018. Presentation agenda CURRENT STATE OF THE POST ACUTE PROVIDER SECTOR. Impact of The Medical Director in Preserving Your Future
Impact of The Medical Director in Preserving Your Future Rajeev Kumar MD FACP Chief Medical Officer Symbria Aaron Hagopian MBA Director of Data Analytics Symbria Copyright 2018 Symbria, Inc. Presentation
More informationCare Plan Appropriateness
Care Plan Appropriateness Accurate Assessment Focused Care October 17, 2012 Director All Hands Pillar Breakout Series Aligning our Work Strive to provide the very best service to our clients. Set specific
More informationEmerging Issues in Post Acute Care Trends
Emerging Issues in Post Acute Care Trends Lavonne Elston, PT Senior Director of Operations & Strategic Initiatives Skilled Nursing & Rehabilitation Kingston HealthCare Company April 28, 2016 Disclosures
More informationPhysician Performance Analytics: A Key to Cost Savings
Physician Performance Analytics: A Key to Cost Savings Session #90, February 21, 2017 Jim Gera, SVP of Business Development, Signature Medical Group, Inc. 1 Speaker Introduction Jim Gera, MBA SVP of Business
More informationThe President s and Other Bipartisan Proposals to Reform Medicare: Post-Acute Care (PAC) Reform. Summary
Current Law The President s and Other Bipartisan Proposals to Reform Medicare: Post-Acute Care (PAC) Reform Summary Home Health Agencies Under current law, beneficiaries who are generally restricted to
More informationVNAA BLUEPRINT FOR EXCELLENCE BEST PRACTICES TO REDUCE HOSPITAL ADMISSIONS FROM HOME CARE. Training Slides
VNAA BLUEPRINT FOR EXCELLENCE BEST PRACTICES TO REDUCE HOSPITAL ADMISSIONS FROM HOME CARE Training Slides 061015 Why Take Action to Prevent Readmissions? Better patient care and patient experience Home
More informationA Brave New World: Lessons Learned From Healthcare Reform. Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage
A Brave New World: Lessons Learned From Healthcare Reform Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage 1 Learning Objectives Participants will understand: The impact health
More informationHome Health Value-Based Purchasing Series: HHVBP Model 101. Wednesday, February 3, 2016
Home Health Value-Based Purchasing Series: HHVBP Model 101 Wednesday, February 3, 2016 About the Alliance 501(c)(3) non-profit research foundation Mission: To support research and education on the value
More informationUsing Benchmarks to Drive Home health Success
Introductory announcements: This provider-directed continuing nursing education activity was approved by the Maryland Nurses Association (MNA) to award contact hours. The MNA is accredited as an approver
More information& Reward. Opportunity, Risk. HealthPRO Heritage National healthcare solutions firm specializing in Care ReDesign for top of market clients 9/5/2018
Opportunity, Risk & Reward Care Redesign Cross Continuum Connections Built on a Foundation of Clinical Innovation Elisa Bovee, MS OTR/L, Vice President of Clinical Strategies 2017 LeadingAge New York Annual
More information5D QAPI from an Operational Approach. Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Pathway Health 2013
5D QAPI from an Operational Approach Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Objectives Review the post-acute care data agenda. Explain QAPI principles Describe leadership
More informationBest Options for Responding to the Home Health PPS 2011 Cuts *revised handouts
Best Options for Responding to the Home Health PPS 2011 Cuts *revised handouts Improve Your Revenues with OASIS and Coding Presented By: Rhonda Marie Will, RN, BS, HCS-D, COS-C Melanie R. Duerr, RN, MS,
More informationWhat is Value-Based Care
Genesis HealthCare Value-Based Care Initiatives and BPCI Model 3 Aug 4, 2017 Copyright 2017 by Genesis HealthCare LLC. All Rights Reserved. What is Value-Based Care 2 Value-based care delivery is an approach
More informationDelivery System Reform The ACA and Beyond: Challenges Strategies Successes Failures Future
Delivery System Reform The ACA and Beyond: Challenges Strategies Successes Failures Future Arnold Epstein MSU 2018 Health Care Policy Conference April 6, 2018 The Good Ole Days 2 Per Capita National Healthcare
More informationOptimizing Operational and Financial
BUNDLING POISED TO TAKE OFF IN MANY MARKETS: White ARE YOU Paper March READY 2016 Optimizing Operational and Financial Performance Darrin Hull Vice President of Senior Care Solutions Health Dimensions
More informationRedesigning Post-Acute Care: Value Based Payment Models
Redesigning Post-Acute Care: Value Based Payment Models Liz Almeida-Sanborn, MS, PT President Preferred Therapy Solutions This session will address: Discussion of the emergence of voluntary and mandatory
More informationThe Role of Pharmacy in Alternative Payment Models
The Role of Pharmacy in Alternative Payment Models July 15, 2015 Disclaimer Organizations may not re use material presented at this AMCP webinar for commercial purposes without the written consent of the
More informationSucceeding in a New Era of Health Care Delivery
March 14, 2012 Succeeding in a New Era of Health Care Delivery Building Value-Based Partnerships LeadingAge Pennsylvania Kathleen Griffin, PhD, National Director Post-Acute and Senior Services 1 Your Presenter
More informationPPS: The Big Picture
PPS: The Big Picture Fall Conference, 2012 Presented by Karen Vance, OTR Supervising Consultant BKD, LLP Colorado Springs, Colorado kvance@bkd.com PPS: The Big Picture Industrial Revolution Urbanization
More informationWisconsin Homecare Organization
Wisconsin Homecare Organization Competitive Strategies: Key Elements for Thriving in a High-Stakes Outcomes Market Lynda Laff Strategic Healthcare Programs, LLC Thursday, May 15, 2008 2:00 p.m. 3:30 p.m.
More informationAlternative Payment Models for Behavioral Health Kim Cox VP, Provider Network
Alternative Payment Models for Behavioral Health Kim Cox VP, Provider Network Kim Cox Vice President, Provider Network, Optum Kim Cox is Vice President of Provider Network. She joined Optum in February
More informationPitch Perfect: Selling Your Services to LTC Facilities
Pitch Perfect: Selling Your Services to LTC Facilities Lou Ann Brubaker, President Brubaker Consulting www.brubakerconsulting.com 301 535 5449 brubak97@aol.com Linkedin Disclosure Lou Ann Brubaker is the
More informationAGENDA. QUANTIFYING THE THREATS & OPPORTUNITIES UNDER HEALTHCARE REFORM NAHC Annual Meeting Phoenix AZ October 21, /21/2014
QUANTIFYING THE THREATS & OPPORTUNITIES UNDER HEALTHCARE REFORM NAHC Annual Meeting Phoenix AZ October 21, 2014 04 AGENDA Speaker Background Re Admissions Home Health Hospice Economic Incentivized Situations
More informationNavigating Therapy Compliance Requirements Across The Continuum. Objectives. Therapy is Occurring Everywhere!
Navigating Therapy Compliance Requirements Across The Continuum Kay Hashagen, PT, MBA, RAC-CT Senior Consultant LW Consulting, Inc. Catherine Gill, MS, PT, MHA Director of Quality and Support Services;
More informationObjectives. Assisted Living. O 2 : Opportunities & Outcomes in Assisted Living. Presented by: Chief Clinical Officer
O 2 : Opportunities & Outcomes in Assisted Living Presented by: Leigh Ann Frick, PT, MBA Chief Clinical Officer Melissa Moffitt, MS, CCC-SLP Senior Vice President of Senior Living Objectives Identify the
More informationSucceeding in Value-Based Care CareConnect Journey
Succeeding in Value-Based Care CareConnect Journey Donna Mueller VP Network Development dmueller@infinityrehab.com 360-201-2703 Jake Arrastia VP Strategy Development & Innovation jrarrastia@infinityrehab.com
More informationData-Driven Strategy for New Payment Models. Objectives. Common Acronyms
Data-Driven Strategy for New Payment Models Mark Sharp, CPA Partner msharp@bkd.com Objectives Understand new payment model reforms and bundling arrangements Learn how these new payment models can impact
More informationMedicare Part A SNF Payment System Reform: Introduction to Resident Classification System - I ZIMMET HEALTHCARE 2018
Medicare Part A SNF Payment System Reform: Introduction to Resident Classification System - I Introduction to the Resident Classification System - I Concepts Structure Implications RCS is NOT the Unified
More informationMedicare Home Health Prospective Payment System (HHPPS) Calendar Year (CY) 2013 Final Rule
Last updated 11/13/12 Contact: Advocacy@apta.org Medicare Home Health Prospective Payment System (HHPPS) Calendar Year (CY) 2013 Final Rule Introduction COMPREHENSIVE SUMMARY On November 2, 2012, the Centers
More informationHHVBP Sessions. HHVBP Overview 6/7/2016. Home Health Value Based Purchasing. Session 1: Overview
Home Health Value Based Purchasing Session 1: Overview Session 1: Overview HHVBP Sessions Future session topics: New Measures Form & KAHL Courses Total Performance Score & State Benchmarks / Achievement
More informationLinking the Coding Process, the OASIS & the POC to Make Them All Work Together
Linking the Coding Process, the OASIS & the POC to Make Them All Work Together Presented by Jennifer Warfield, RN, BSN, HCS-D, COS-C Education Director PPS Plus Software Linking the Coding Process, the
More informationIntroduction 4/7/2015
The Perfect Storm: A Distinguished Post-Acute Rehabilitation Program (Session # W25) Wednesday April 29 th, 2:30-4:30 Presented by: Hilary Forman PT, RAC-CT Senior Vice President of Clinical Strategies
More informationDRIVING VALUE-BASED POST-ACUTE COLLABORATIVE SOLUTIONS. Amy Hancock, CEO Presented to: CPERI April 16, 2018
DRIVING VALUE-BASED POST-ACUTE COLLABORATIVE SOLUTIONS Amy Hancock, CEO Presented to: CPERI April 16, 2018 Cross-Continuum Road-Mapping Post-acute partners are beginning to utilize tools to identify new
More informationCare Coordination in the New CoP s. Teresa Northcutt BSN RN COS-C HCS-D HCS-H WiAHC June 2017
Care Coordination in the New CoP s Teresa Northcutt BSN RN COS-C HCS-D HCS-H WiAHC June 2017 Selman-Holman & Associates, LLC Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C Home Health Insight Consulting,
More informationPASRR: Partnering with Hospitals in Meeting Patient s Needs
PASRR: Partnering with Hospitals in Meeting Patient s Needs PASRR Technical Assistance Center February 14, 2012 90 minutes Presenter: Jackie Birmingham, RN, BSN, MS, CMAC Agenda Introduction why PASRR
More information2017 FOCUSED ON DOCUMENTATION NECESSITIES & PRE-CLAIM REVIEW
2017 FOCUSED ON DOCUMENTATION NECESSITIES & PRE-CLAIM REVIEW PRESENTED BY: MELINDA A. GABOURY, COS-C CHIEF EXECUTIVE OFFICER HEALTHCARE PROVIDER SOLUTIONS, INC. HEALTHCAREPROVIDERSOLUTIONS.COM ADDITIONAL
More informationPhysician Estimate of Length of Services
Physician Estimate of Length of Services Can the physician estimate of length of services be longer than 60 days? The physician estimate of length of service can be longer than 60 days. This estimate is
More informationPresentation Objectives
Quality Improvement and Value-Based Purchasing (VBP) How your QI program can prepare you for transformation Paul Mulhausen, MD, AGSF, FACP Medical Director Telligen Quality Improvement Network Quality
More informationMeasuring the Real Impact of Clinical Documentation Improvement On Value-based Reimbursement
White Paper Measuring the Real Impact of Clinical Documentation Improvement On Value-based Reimbursement June 2016 Shane Wolverton Senior Vice President of Corporate Development Quantros, Inc. Anthony
More informationPointRight: Your Partner in QAPI
A N A LY T I C S T O A N S W E R S E X E C U T I V E S E R I E S PointRight: Your Partner in QAPI J A N E N I E M I M S N, R N, N H A Senior Healthcare Specialist PointRight Inc. C H E R Y L F I E L D
More informationPartners in the Continuum of Care: Hospitals and Post-Acute Care Providers
Partners in the Continuum of Care: Hospitals and Post-Acute Care Providers Presented to the Wisconsin Association for Home Health Care November 3, 2017 By: Laura Rose WHA Vice President, Policy Development
More informationRAC Audits and Denials Management WHCA Fall Conference September 9, 2014
JoLynn Munro, MS,OTR/L, Regional Vice President Infinity Rehab Carolyn Staples, CCC/SLP, Area Rehab Director Infinity Rehab RAC Audits and Denials Management WHCA Fall Conference September 9, 2014 Objectives
More informationHHGM is Alive and Kicking: How Can You Prepare for What s Next?
HHGM is Alive and Kicking: How Can You Prepare for What s Next? New England Home Care & Hospice Conference and Trade Show April 26, 2018 Presented by: Chris Attaya VP of Product Strategy, SHP Sue Payne
More informationEnhancing QiRePort To Support On-Line PCS Service Planning (Update/Status Report) PCS Regional Provider Training Sessions: October 13-30, 2014
Enhancing QiRePort To Support On-Line PCS Service Planning (Update/Status Report) PCS Regional Provider Training Sessions: October 13-30, 2014 Today s Presentation Provide An Overview Of The Proposed Enhancements
More informationREPORT OF THE BOARD OF TRUSTEES
REPORT OF THE BOARD OF TRUSTEES B of T Report 21-A-17 Subject: Presented by: Risk Adjustment Refinement in Accountable Care Organization (ACO) Settings and Medicare Shared Savings Programs (MSSP) Patrice
More informationAugust 25, Dear Ms. Verma:
Seema Verma Administrator Centers for Medicare & Medicaid Services Hubert H. Humphrey Building 200 Independence Avenue, S.W. Room 445-G Washington, DC 20201 CMS 1686 ANPRM, Medicare Program; Prospective
More informationICD 10 CM State of Transition
ICD 10 CM State of Transition Tricia A. Twombly, RN, BSN, HCS D, HCS C, COS C, CHCE, AHIMA ICD 10 Trainer, ICE Certified Credentialing Specialist, CEO Board of Medical Coding and Compliance, Senior Director
More informationThe National ACO, Bundled Payment and MACRA Summit. Success in Physician Led Bundles
The National ACO, Bundled Payment and MACRA Summit Success in Physician Led Bundles Disclaimer This material and/or presentation is provided for guidance and/or illustrative purposes only and should not
More informationA Tool for Maximizing Quality in Your Organization
OASIS C: A Tool for Maximizing Quality in Your Organization Debbie Costello RN BSN MSM Director of Quality & Safety Caritas Home Care Session Outline Events leading to change in OASIS C Progress in home
More informationThe Home Health Groupings Model (HHGM)
The Home Health Groupings Model (HHGM) September 5, 017 PRESENTED BY: Al Dobson, Ph.D. PREPARED BY: Al Dobson, Ph.D., Alex Hartzman, M.P.A, M.P.H., Kimberly Rhodes, M.A., Sarmistha Pal, Ph.D., Sung Kim,
More informationCMS OASIS Q&As: CATEGORY 2 - COMPREHENSIVE ASSESSMENT
CMS OASIS Q&As: CATEGORY 2 - COMPREHENSIVE ASSESSMENT Q1. When are we required to collect OASIS? [Q&A EDITED 06/14] A1. The Condition of Participation (CoP) published in January 1999 requires a comprehensive
More informationMedicare, Managed Care & Emerging Trends
Medicare, Managed Care & Emerging Trends LeadingAge Michigan 2015 Annual Leadership Institute August 12, 2015 Jon Lanczak, Manager Beth Sullivan, Senior Manager Plante Moran, PLLC Overall Theme Healthcare
More informationUsing Data to Yield High Impact Business Intelligence Wednesday, July 25, 2012
Using Data to Yield High Impact Business Intelligence Wednesday, July 25, 2012 Brent J. Estes President and CEO, Rush Health About Rush Rush University Medical Center 673 Beds 36,000 admissions 391,700
More informationAssessment Overview. David Lloyd, Founder M.T.M. Services
Integrated Healthcare Readiness Assessment Overview Presented by: M.T.M. Services P. O. Box 1027, Holly Springs, NC 27540 Phone: 919-434-3709 Fax: 919-773-8141 E-mail: david.lloyd@mtmservices.org Web Site:
More informationQuality Outcomes and Data Collection
Quality Outcomes and Data Collection Presented By: Joanne Jones Director, Clinical Consulting Services August 30, 2016 Quality Measurement in LTC CMS Nursing Home Compare 5 Star Rating System New measures
More informationWhat s Next for CMS Innovation Center?
What s Next for CMS Innovation Center? A Guide to Building Successful Value-Based Payment Models Given CMMI s New Focus on Voluntary, Home-Grown Initiatives W W W. H E A L T H M A N A G E M E N T. C O
More informationTherapy Documentation: What is Reasonable and Necessary?
Therapy Documentation: What is Reasonable and Necessary? Presented By: Cindy Krafft MS PT, COS-C Director of Rehabilitation Consulting Services President - Home Health Section APTA June 15, 2010 243 King
More informationCreating a Virtual Continuing Care Hospital (CCH) to Improve Functional Outcomes and Reduce Readmissions and Burden of Care. Opportunity Statement
Creating a Virtual Continuing Care Hospital (CCH) to Improve Functional Outcomes and Reduce Readmissions and Burden of Care Robert D. Rondinelli, MD, PhD Paulette Niewczyk, MPH, PhD AlphaFIM, FIM, SigmaFIM,
More informationData Stewardship: Essential Skills for Long Term Care Facility Managers
Data Stewardship: Essential Skills for Long Term Care Facility Managers PRESENTED BY LEAH KLUSCH EXECUTIVE DIRECTOR THE ALLIANCE TRAINING CENTER ALLIANCE, OHIO 330-821-7616 leahklusch@sbcglobal.net Data
More informationGlobal Budget Revenue. October 8, 2015
Global Budget Revenue October 8, 2015 Goals Understand GBR s connection to the goals of Maryland s Demonstration Understand impact on budgeting and planning for RFP and future phases Answer questions that
More information3/21/2018. Foundation Management Services, Inc All rights reserved. Unauthorized reproduction is strictly prohibited.
Keys to Documentation Success in Home Health Coding DISCLAIMER This material is designed and provided to communicate information about compliance, ethics and coding in an educational format and manner.
More informationIs HIT a Real Tool for The Success of a Value-Based Program?
Is HIT a Real Tool for The Success of a Value-Based Program? Sally Montes, MPH, RHIA, CCHP President, SM & Associates, Inc. smontes@sm-asociados.com (787) 306-1149 President, PR HFMA Chapter INTRODUCTION
More information5/26/2015. January 26, 2015 INCENTIVES AND PENALTIES. Medicare Readmission Penalties. CMS Bundled Payment Providers & ACOs in NE
Agenda ESTABLISHING SHARED EXPECTATIONS New tool of ACOs, Bundled Payments & Readmission Reduction Update on current market pressures driving a focus on care across settings & over time at lowest cost
More informationMedicare Part A Update
Medicare Part A Update Jennifer Bogenrief, JD Manager, Regulatory Affairs AOTA AOTA Specialty Conference: Effective Documentation Friday, September 12, 2014 1 Topics Medicare Therapy Documentation Requirements
More informationRegulatory Compliance Risks. September 2009
Rehabilitation Regulatory Compliance Risks September 2009 1 Agenda - Rehabilitation Compliance Risks Understand the basic requirements for Inpatient Rehabilitation Facilities (IRFs) and Outpatient Rehabilitation
More informationHOW BPCI EPISODE PRECEDENCE AFFECTS HEALTH SYSTEM STRATEGY WHY THIS ISSUE MATTERS
HOW BPCI EPISODE PRECEDENCE AFFECTS HEALTH SYSTEM STRATEGY Jonathan Pearce, CPA, FHFMA and Coleen Kivlahan, MD, MSPH Many participants in Phase I of the Medicare Bundled Payment for Care Improvement (BPCI)
More informationOutcomes Measurement in Long-Term Care (LTC)
ASHA Short Course Outcomes Measurement in Long-Term Care (LTC) Bill Goulding, MS/CCC-SLP November 19, 2012 How Do We Show Value? Easy to measure! Not so easy! V $$$ A L Impact? Cost U Benefit E What do
More informationThe Challenges and Opportunities in Using Data Bundled Payment, Care Improvement
The Challenges and Opportunities in Using Data Bundled Payment, Care Improvement Helen Macfie, Pharm.D., FABC For IHI Leading Population Heath Transformation February, 2017 It started with a project PHYSICIAN
More informationA Practical Approach Toward Accountable Care and Risk-Based Contracting: Design to Implementation
A Practical Approach Toward Accountable Care and Risk-Based Contracting: Design to Implementation Daniel J. Marino, President/CEO, Health Directions Asad Zaman, MD June 19, 2013 Session Objectives Establish
More informationHome Health Market Overview
Home Health Market Overview December 2013 Investment banking services are provided by Harris Williams LLC, a registered broker-dealer and member of FINRA and SIPC, and Harris Williams & Co. Ltd, which
More informationSNF proposed rule revisions to case-mix methodology
SNF proposed rule revisions to case-mix methodology Comments due: August 25, 2017 CMS intent to propose case-mix refinements in the FY 2019 SNF PPS proposed rule Summary of changes Goals of the change:
More informationForces of Change- Seeing Stepping Stones Not Potholes
May 19, 2014 Forces of Change- Seeing Stepping Stones Not Potholes 2 3 4 Overview Demographics Long Term Care Financing Challenges Broad Health System Challenges Payment Reform Delivery System Reform Where
More informationOASIS C2 Strategies for Success
OASIS C2 Strategies for Success Presented by Selman-Holman & Associates, LLC Selman Holman & Associates, LLC Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C Home Health Insight Consulting, Education and
More informationHome Assessments Resulting in a Positive Effect on Outcome Score Cards
Home Assessments Resulting in a Positive Effect on Outcome Score Cards Presented by: Angela Benson, OTR/L, Clinical Specialist *graduated from Mount Aloysius College, Cresson, PA *9 years of experience
More informationMedicare Part A SNF Payment System Reform: Introduction to Resident Classification System - I
Medicare Part A SNF Payment System Reform: Introduction to Resident Classification System - I Introduction to the Resident Classification System - I Concepts Structure Implications RCS is NOT the Unified
More informationRE: CMS-1622-P; Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2016
June 12, 2015 Andrew M. Slavitt Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1622-P Room 445-G Hubert H. Humphrey Building 200
More informationMDS FOR THE ADMINISTRATOR: WHAT YOU NEED TO KNOW
MDS FOR THE ADMINISTRATOR: WHAT YOU NEED TO KNOW LIBBY YOUSE, LNHA Long Term Care Leadership Coach OBJECTIVES Understanding factors why MDS s are so important in your home Identify the effects it places
More informationPart 2: OASIS C2 Accuracy
Part 2: OASIS C2 Accuracy Presented by: Sharon Molinari, RN, HCS D, HCS O For: HealthCare Synergy Patient Tracking Items M0010 M0150 Completed at SOC and updated when a change occurs in the episode. 1
More informationOASIS-C2 FIELD GUIDE TO DATA COLLECTION
OASIS-C2 FIELD GUIDE TO DATA COLLECTION Outcome and Assessment Information Set OASIS-C2 Guidance Manual Effective January 1, 2018 Manual: Effective January 1, 2018 Q&A from November 2016 Categories 1 through
More informationAccountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011
Accountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011 Cary Sennett MD PhD Cary Sennett, MD, PhD Managing Director, Engelberg Center for Health Care Reform
More informationInnovations in Community- Based Advanced Illness Care: A Population Health Approach
Innovations in Community- Based Advanced Illness Care: A Population Health Approach LORI YOSICK, LISW -S, CHPCA DIRECTOR COMMUNITY PALLIATIVE CARE TRINITY HEALTH TERRI MAXWELL PHD, APRN CHIEF CLINICAL
More informationQuality Measurement at the Interface of Health Care and Population Health
1 Institute of Medicine Committee on Quality Measures Healthy People Leading Health Indicators December 10, 2012 Quality Measurement at the Interface of Health Care and Population Health Shari M. Ling,
More informationSHP FOR AGENCIES. 102: Reporting and Performance Improvement. Zeb Clayton Vice President of Client Services. v4.00
SHP FOR AGENCIES 102: Reporting and Performance Improvement Zeb Clayton Vice President of Client Services v4.00 Technical Tips Click the red arrow on the upper left to hide the GoToWebinar control panel
More informationClinical Documentation Improvement (CDI) Programs: What Role Should Compliance Play?
Clinical Documentation Improvement (CDI) Programs: What Role Should Compliance Play? June 17, 2016 Agenda Clinical Documentation Improvement (CDI) Perspective An Effective CDI Program Core Focus: Compliance
More informationSHP Access 6/7/2016. Objectives. SHP Alerts. https://shpdata.com/ You will need a user name and password
SHP Alerts Objectives By the end of this session, attendees will be able to: Activate and access SHP alerts Integrate SHP alerts into the daily workflow of clinicians and the MCP role Address alerts to
More informationHOME HEALTH VALUE BASED PURCHASING FREQUENTLY ASKED QUESTIONS Updates in Red
1. What is the contact information of the Home Health Value-Based Purchasing (HHVBP) Helpdesk? General HHVBP The HHVBP Helpdesk can be reached by email at HHVBPquestions@cms.hhs.gov). The Helpdesk number
More informationEuclid Hospital CMS BPCI Episode
Euclid Hospital CMS BPCI Episode Two Paradigms in Health Care Reform Managing population 1 health, 2 PCMH Managing episodes of care, Bundled payments Health Status Baseline Episode Total Spend: Commercial
More informationCY2019 Proposed Medicare Home Health Rate Rule and Much More
Medicare Home Health Proposed Rule July 13, 2018 William A. Dombi President wad@nahc.org Mary K. Carr Vice President mkc@nahc.org CY2019 Proposed Medicare Home Health Rate Rule and Much More Published
More informationMEDICARE UPDATES: VBP, SNF QRP, BUNDLING
MEDICARE UPDATES: VBP, SNF QRP, BUNDLING PRESENTED BY: ROBIN L. HILLIER, CPA, STNA, LNHA, RAC-MT ROBIN@RLH-CONSULTING.COM (330)807-2850 MEDICARE VALUE BASED PURCHASING 1 PROTECTING ACCESS TO MEDICARE ACT
More informationCritical Revenue Growth Strategies for Home Health Agencies. NAHC Annual Conference Nashville, TN October 28, 2015 Session 102
Critical Revenue Growth Strategies for Home Health Agencies NAHC Annual Conference Nashville, TN October 28, 2015 Session 102 Jeff Aspacher, VP Finance and CFO Community Health System Nick Seabrook, Managing
More informationHow to Survive Audits By Accurately Documenting Medical Necessity. Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus
How to Survive Audits By Accurately Documenting Medical Necessity Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus How to Survive Audits By Accurately Documenting Medical
More informationExecutive Summary. This Project
Executive Summary The Health Care Financing Administration (HCFA) has had a long-term commitment to work towards implementation of a per-episode prospective payment approach for Medicare home health services,
More informationNYS Value Based Payments (VBP):
NYS Value Based Payments (VBP): Provider Associations, Community Based Organizations, and Consumer Advocates Town Hall Meeting Jason Helgerson NYS Medicaid Director December 16, 2016 2 Today s Agenda Agenda
More information