Category: Home Health Quality Reporting
PDGM Series: The 2020 Proposed Rule Update
By Melinda A. Gaboury, CEO / Posted on: August 27, 2019January 1, 2020 will bring many new beginnings, including the Patient Driven Groupings Model (PDGM). No doubt the largest reimbursement system overhaul in home health since October 2000.
CMS continues to tweak the model and updates to the Claims Processing Manuals have begun.
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OASIS-D1 Update & PDGM Impact
By Melinda A. Gaboury, CEO / Posted on: July 1, 2019CMS has announced that the revised OASIS-D1 instruments will be effective January 1, 2020. Changes to the OASIS-D data set and data collection guidance were finalized in the Calendar Year (CY) 2019 HH Final Rule, CMS 1689-FC.
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Are You Prepared? The Patient Driven Groupings Model (PDGM) Is Coming Soon
By Melinda A. Gaboury, CEO / Posted on: April 30, 2019Home health agencies may find many of the changes to OASIS-D daunting, but there are several modifications that have helped make assessments easier than ever before. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) is the primary driving force behind the OASIS changes.
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OASIS-D: ARE YOU READY FOR 2019?
By Melinda A. Gaboury, CEO / Posted on: October 30, 2018OASIS has indeed changed again and quite dramatically this time. While there are 28 M items that have been deleted from the data set and only 6 new ones added, don’t be fooled into believing that this will be a breeze.
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2019 Value Based Purchasing Proposed Changes (UPDATED)
By Melinda A. Gaboury, CEO / Posted on: August 27, 2018The Centers for Medicare and Medicaid Service (CMS) finalized all of the proposed changes to the Value-Based Purchasing (VBP) Model for implementation January 1, 2019. One of the refinements of VBP removed five measures, while adding two new composite measures.
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2019 Home Health Proposed Payment Rule – PDGM 2020
By Melinda A. Gaboury, CEO / Posted on: August 8, 2018The Centers for Medicare and Medicaid Service (CMS) released the CY2019 Medicare Home Health payment rule July 12, 2018. This proposed rule is voluminous and carries an immense number of proposed changes. HPS will continue analyzing and updating the proposed elements of this rule.
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CAHPS – Home Health & Hospice
By Melinda A. Gaboury, CEO / Posted on: March 2, 2018Are you monitoring the agency’s CAHPS results? There are numerous questions on the survey that the patients must complete, but only selected ones go into the outcome measure calculations. Home Health CAHPS results have been reported on the Home Health Compare website for quite some time, while the results for the CAHPS Hospice Survey just began being public reported on Hospice Compare 02/22/18. One of the lowest scoring…
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2018 Home Health Final Rule
By Melinda A. Gaboury, CEO / Posted on: November 14, 2017The Breaking News that has every one full of excitement and hope is that the 2018 Home Health Final Rule does NOT include finalizing HHGM, at this time, which was set for implementation in 2019! The battle has been won, BUT the war has just begun! Some form of payment reform will occur in home health. It is not…
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2018 Home Health Proposed Rule – HH QRP
By Melinda A. Gaboury, CEO / Posted on: August 14, 2017The 2018 Home Health Proposed Rule was released 07/28/17. The 2018 Home Health Proposed Payment Rule – Including Intro to HHGM regarding this rule primarily discussed the proposed reimbursement changes for 2018 as well as the massive changes to the Prospective Payment System in the form of HHGM. The following is a recap of the proposed changes to the Home Health Quality Reporting Program (HH QRP).
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2018 Home Health Proposed Payment Rule – Including Intro to HHGM
By Melinda A. Gaboury, CEO / Posted on: July 31, 2017The Centers for Medicare and Medicaid Service (CMS) released the CY2018 Medicare Home Health payment rule last week. This proposed rule is voluminous and carries an immense number of proposed changes. HPS will continue analyzing and updating on the proposed elements of this rule.
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Delayed Implementation of Home Health CoPs
By Melinda A. Gaboury, CEO / Posted on: July 14, 2017Last week CMS issued a Final Rule that changed the new Home Health CoPs rule implementation date to January 13, 2018. HPS announced the proposed rule a few months ago. NAHC and the Forum of State Associations spearheaded this effort to postpone the rule because of the extensive changes that are…
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Home Health PEPPER is HOT!
By Melinda A. Gaboury, CEO / Posted on: May 26, 2017One of the Hot Topics surrounding the medical review contractors and Medicare MACs is Home Health PEPPER (Program for Evaluating Payment Patterns Electronic Report)! Pepper is an accumulation and calculation of certain statistics that result from claims data. These Medicare claims data statistics are calculated for areas that may be at risk for improper Medicare payments such as…
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HHCAHPS – Improvement in Specific Care Issues
By Melinda A. Gaboury, CEO / Posted on: May 12, 2017Are you monitoring the agency’s HHCAHPS Star Ratings? There are numerous questions on the survey that the patients must complete, but only selected ones go into the outcome calculation and eventual star rating. The Composite Measure – Specific Care Issues, seems to be one that most agencies struggle with. The specific questions from the survey…
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Negative Pressure Wound Therapy with a Disposable Device Billing Specifics (NPWT)
By Melinda A. Gaboury, CEO / Posted on: April 21, 2017The 2017 Final Home Care Rule included clarification that payment for the NPWT device is when a HHA “furnishes NPWT using a disposable device” to mean when the HHA provider is either initially applying an entirely new disposable NPWT device, or removing a disposable NPWT device and replacing it with an entirely new one.
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Home Health COPs Delayed
By Melinda A. Gaboury, CEO / Posted on: March 31, 2017CMS just issued a proposed rule that will change the new Home Health CoP rule effective date to January 13, 2018. NAHC and the Forum of State Associations spearheaded an effort to postpone the rule because of the extensive changes that are required and the absence of needed interpretive guidance to properly comply.
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Are You Thriving?
By Melinda A. Gaboury, CEO / Posted on: January 20, 2017The constant additions of new programs and new methods, updates and consideration of changes is almost unbearable for some agencies. Home Health has been hit really hard since 2008 and no relief seems to be coming. Value-Based Purchasing, Pre-Claim Review, New CoPs, OASIS-C2, ICD-10 CM and now possibly major changes to the Prospective Payment System in regard to reimbursement.
VIEW POSTBREAKING NEWS – PRE-CLAIM REVIEW DELAYED
By Melinda A. Gaboury, CEO / Posted on: September 20, 2016…
VIEW POSTHHCAHPS – Is There Room for Improvement?
By Melinda A. Gaboury, CEO / Posted on: April 28, 2016…
VIEW POSTThe Continued Culture Change to Quality
By Melinda A. Gaboury, CEO / Posted on: April 8, 2016…
VIEW POSTValue Based Purchasing: What We Weren’t Sure of!
By Melinda A. Gaboury, CEO / Posted on: January 14, 2016…
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