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OCHCH 2023 Annual Conference & Tradeshow

Speaker(s): Melinda A. Gaboury, CEO & Leslie Heagy, Director of Clinical Services

Category: Conference

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Speaker(s): Melinda A. Gaboury, CEO & Leslie Heagy, Director of Clinical Services

About the Speaker(s)

Melinda A. Gaboury, with more than 30 years in home care, has over 22 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 as the Chair of the NAHC/HHFMA Advisory Board and Work Group and is currently serving on the Board of Directors for both the Home Care Association of Florida & Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E  and Home Health Billing Answers, 2023.

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OCHCH 2023 Annual Conference & Tradeshow Sep 26 - Sep 27, 2023

About the Event

Hospice Eligibility Documentation | Leslie Heagy, Director of Clinical Services

Accurate hospice eligibility documentation is critical to fulfilling the CoPs and payment requirements. The lack of supporting documentation for a terminal prognosis is the number one reason for denial. Reviewers often look for a significant decline in patient condition. Although this is not a requirement of hospice care, terminal prognosis is. The webinar will help clinicians document the slightest changes in baseline measures. More importantly, you’ll learn how to capture in documentation the occurring changes that support terminal prognosis – even without a decline in baseline measures. Go beyond the LCDs and common tools for documenting eligibility by drilling down to the details and characteristics that differentiate terminal and chronic patients with the same diagnosis.

Hospice VBID | Melinda A. Gaboury, CEO

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.

Home Health PDGM & Value Based Purchasing 2023 | Melinda A. Gaboury, CEO

Combine the Centers for Medicare & Medicaid Services (CMS) Home Health Value-Based Purchasing (HHVBP) and their case-mix classification model, the Patient-Driven Groupings Model (PDGM) and you have tons of work as Medicare-certified home health agencies are going to find! Agencies are pitted against each other and given incentives for better quality care under the HHVBP while being forced to survive under the rate cuts and constant scrutiny of the PDGM model. CMS simultaneously seeks to enhance the current public reporting process and the outcome measures associated. January 2023 was the first month of the nationwide HHVBP rollout, how will your agency fare?  This session will include a look at the HH Final Rule, including a brief update to the rates and changes to the PDGM key components. We will also review the pre-implementation reports from HHVBP and how agencies can use those moving forward and analyze how the HHVBP model affected outcome scores for every provider. Melinda Gaboury of Healthcare Provider Solutions will present her knowledgeable, very frank, and clear insights and suggestions on how to implement improvements within your agency.