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Speaker(s): Melinda A. Gaboury, CEO, Leslie Heagy, RN, COS-C
About the Speaker(s)
Melinda A. Gaboury, with more than 29 years in home care, has over 20 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving on the NAHC/HHFMA Advisory Board and Work Group and is Treasurer on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1 and Home Health Billing Answers, 2021.
About the Event
Day 1 May 10th – Melinda A. Gaboury
- 10:45 AM – 12:15 PM: Hospice VBID
This session will cover the details of the Value-Based Insurance Design (VBID) Model – Hospice Benefit Component. Medicare Advantage (MA) has long had coverage for home health patients, but there has never been coverage for Hospice under the MA benefit. VBID is a demonstration that began January 1, 2021 and continues for 5 years. There are multiple Medicare Advantage Organizations (MAO) that are participating and have coverage in multiple states. In addition to Hospice care there is an expansion of Palliative Care services that are offered to patients through the MAO. CMS is testing how the hospice benefit component can improve beneficiary care through greater care coordination, reduced fragmentation, and transparency in line with recommendations by the Office of Inspector General (OIG), the Medicare Payment Advisory Commission (MedPAC) and others. Hospice must prepare as more and more MAOs are participating in VBID to offer the hospice benefit to their beneficiaries.
- 1:45 – 3:15 PM: Home Health Value Based Purchasing
Value Based Purchasing full implementation is set to begin January 2023. There is much to learn about the details of the outcome calculations. This session will take you through the detail calculations of the VBP Model. It will look at how the agencies did in the demonstration that took place in 9 states. It will also detail what we know to be the calculations of the TPS and the Linear Exchange Function for the nationwide rollout.
- Review the structure to the HHVBP that ended in 2020
- Review results from the HHVBP Demo
- Review the changes to the measures included in HHVBP
- Review the changes in the calculation methodology
- Review what agencies should do to prepare for nationwide rollout
Day 1 May 10th Leslie Heagy
Day 1 – Concurrent Sessions 1:45 – 3:15 PM
Building a Successful QAPI Program – Hospice – Building a Successful Hospice QAPI Program to improve patient outcomes while meeting regulatory compliance. In this session we will focus on understanding the QAPI Conditions of Participation (CoPs) required for all Medicare Certified Hospice providers. We will discuss the Importance of Developing and Implementing a Written QAPI plan that includes the collection and analysis of meaningful data, how to Develop Quality Indicators and Performance Improvement Projects (PIPs) and Strategies for ongoing monitoring to ensure your QAPI program is effective. Healthcare Provider Solutions
Day 1 – Concurrent Sessions: 3:30 – 5:00pm
114 – Building a Successful QAPI Program – Home Health – Building a Successful Home Health QAPI Program – In this session we will focus on understanding the QAPI Conditions of Participation (CoPs) required for all Medicare Certified Home Health Agencies. We will discuss the steps for building a simple but well-defined QAPI Program to improve actual patient outcomes while achieving regulatory compliance. You will learn what is needed to develop and implement a written QAPI plan that includes the collection of meaningful data and the analysis of that data for High Risk, High Volume, and Problem Prone areas. We will discuss when Quality Indicators and Performance Improvement Projects (PIPs) are needed as well as, best practices for ongoing monitoring to ensure your QAPI program is effective.