EVENTS
TAHC 2022 Fall Conference
Speaker(s): Melinda A. Gaboury, CEO & Leslie Heagy, Director of Clinical Services
Category: Speaking EngagementConference
- This event has passed.
Speaker(s): Melinda A. Gaboury, CEO & Leslie Heagy, Director of Clinical Services
About the Speaker(s)
Melinda A. Gaboury is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc. (HPS). Melinda Gaboury and Mark Cannon founded the company in April 2001 to provide financial, reimbursement, billing, operational and clinical consulting to the home care and hospice industries.
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 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, 2022.
Nov 148:00 am - 5:00 pm CST
About the Event
Value-Based Purchasing – Calculations of the Total Performance Score | 11/14/2022 | 10:25 AM – 11:55 AM
Presenter: Melinda A. Gaboury, COS-C, CEO
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. Will also provide screens for education with staff regarding specific OASIS & HHCAHPS items.
• Detail the calculation process and statistics from the demonstration for Home Health VBP
• Review what agencies should do to prepare for nationwide rollout coming in 2023
• Detail the calculation of the Total Performance Score – Improvement & Achievement
• Review examples of the Linear Exchange Function calculation used to determine impact on future payments
Medicare Medical Review & PEPPER Update | 11/14/2022 | 1:20 PM – 2:35 PM
Presenter: Melinda A. Gaboury, COS-C, CEO
This session will take agencies through the winding road of Medicare scrutiny. Don’t be caught in the position of believing that everything is just okay or that the Public Health Emergency is a shield from medical review. 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 the levels of Medical Review that are currently active: including, UPIC, SMRC, MAC ADR, RAC and the reinstated Targeted Probe & Educate. The session will review how to respond to any level of medical review that may occur. Attendees will take away information that will assist in assuring that your home health truly is accurately documenting. This session will include a brief PEPPER Update.
• Outline the Multiple Post Payment Review Contractors
• List the current edits being used in targeting home health agencies across the nation
• Detail the requirements for successfully submitting medical records for review
Hospice Medical Review & PEPPER | 11/14/2022 | 10:25 AM – 11:55 AM
Presenter: Leslie Heagy, RN, COS-C, Director of Clinical Services
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 you can do to avoid denials. Participants will be able to define the levels of Medical Review that are currently active including: UPIC, SMRC, MAC ADR, and RAC. We will review how to respond to any level of medical review that may occur. This session will also discuss PEPPER reports and other data analysis that agencies will need to review to ensure that their risk from medical review is limited. Do not be caught in the position of believing that everything is just okay or that the Public Health Emergency is a shield from medical review. Attendees will take away information that will assist in assuring that your hospice truly is accurately documenting.
• Detail the top reasons hospices are targeted for medical review that correlate to the PEPPER Report
• Outline the targets that are calculated on the PEPPER Reports
• Detail the targets and other data from the PEPPER reports that is used to evaluate a hospice’s performance
Hospice Quality Reporting Program (HQRP) | 11/14/2022 | 1:20 PM – 2:35 PM
Presenter: Leslie Heagy, RN, COS-C, Director of Clinical Services
This session will describe the components of the Hospice Quality Reporting Program (HQRP) and the financial impact for hospice providers who do not meet the reporting requirements. You will learn the changes in the HQRP that were finalized in the Hospice FY 2023 payment rule including the new Hospice Care Index (claims-based) measure, an update on the Hospice Visits in the Last Days of Life (HVLDL) measure, STAR rating for the hospice CAHPS survey and removal of the seven HIS measures from Care Compare. This session will also provide an update on the HOPE tool.