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MHCA 49th Annual Meeting and Expo

Speaker(s): Melinda A. Gaboury, CEO

Category: Speaking EngagementConference

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MHCA 49th Annual Meeting and Expo May 14 - May 16, 2019
Hosted by
Minnesota HomeCare Association

About the Event

Geared for the wide spectrum of dedicated home care providers seeking knowledge and value, this adventure themed event is a can’t-miss opportunity! Make plans now to send multiple staff, so you can partake in all of the concurrent education sessions within the Leadership, Clinical, & Regulatory/Licensure tracks.

Speaker: Melinda A. Gaboury, CEO | Tuesday, May 14, 2019 | 1:00 PM – 5:00 PM CST | Half Day Pre-Conference PDGM

The most significant change in Homecare Reimbursement in 20 years will go into effect January 2020. The Patient Driven Groupings
Model – PDGM is complicated, confusing and overwhelming. CMS has provided some data on the revenue impacts and new PDGM
components, but there is more to be considered. Clinical & Operational areas likely impacted under the new payment model include
referral and sales management, intake, revenue cycle, operational reporting, order and supply management and much more. This
session will highlight the areas impacted and outline potential process changes to assist in optimizing operations performance under

1. Outline how agencies will need to consider process changes in their business operations as a result of PDGM
2. Define key operations points that will likely require changes and the risks involved if adequate changes are not made
3. Outline potential strategies for process revisions and adjustments to achieve a successful operational transition under PDGM
4. Share meaningful insights on clinical categories, utilization and other characteristics using claims data
5. Provide data drill downs on Therapy Utilization, lengths of stay, LUPAs and other operational metrics under PDGM
6. Provide a Checklist of things to begin implementing today be to ready for a 2020 implementation.

Speaker: Melinda A. Gaboury, CEO | Wednesday, May 15, 2019 | 4:15 PM – 5:15 PM CST | Mitigating Risk & Conditions of Payment

This session will take agencies through the winding road of Medicare scrutiny. While billing the Medicare benefit and getting paid relatively
easy, there is always a risk of things being reviewed at some point and what can you do to avoid denials. Participants will be able to define
Targeted Probe & Educate (TPE) and outline the structure of how to respond to any level of medical review that may occur. This session will
discuss PEPPER reports and other data analysis that agencies will need to review to ensure that their risk from medical review is limited.

1. Review the Targeted Probe & Educate Pilot and other review programs/contractors that CMS is utilizing to review agencies.
2. Identify elements that affect the selection of the agency for review including prior ADR results, PEPPER Reports and other data.
3. Detail the requirements for successfully submitting medical records for review
4. Review checklist for submitting records & key elements of documentation

Stop by our booth and see Melinda!