CMS has anticipated that home health agencies will adjust their documentation and coding practices under PDGM. As a response, CMS will implement a negative behavioral adjustment of 4.36% (based on final rule) to all episodes under the new payment model. According to the final rule issued on Oct 31, 2019, the following are the three…
The new Patient-Driven Groupings Model (PDGM) proposed by CMS will take effect on January 1st, 2020. Drastic changes in the home health industry are anticipated as this modification will greatly affect the process by which therapy services are reimbursed. Furthermore, this switch will enforce new case-mix weight calculations and shorter payment periods. With only a…
Note: In the interest of client confidentiality, the agency name was changed for this case study. When their documentation process was streamlined, this agency shifted to focus more on patient care and scaling the business —allowing them to grow by 65% in less than a year. Endeavor Home Health in California set out to…
To support compliance with Medicare’s new Conditions of Participation (CoPs), Kinnser’s new Progress to Goals feature was introduced to promote patient-specific and measurable goal tracking. While it purportedly offers more efficient documentation, it has also presented challenges for some agencies adjusting to the new functionality. This new feature is currently optional, but we wouldn’t be…
The new Medicare Conditions of Participation (CoPs) took effect last January 13, 2018, and we expect it to be just the first of many changes geared towards improving quality of care and protecting the rights of beneficiaries. The new rules will greatly impact home health agencies, requiring a patient-centered care coordination, effective communication and better…
Offshore outsourcing is a major step for your home health agency, but is it really legal? The answer is yes. Outsourcing offshore is totally legal. In fact, US legislation has passed specific regulations and clear guidelines for healthcare providers and their outsourcing partners. More US companies are leaning towards outsourcing their processes overseas, and the…
Published Mar 31, 2017 | 08:37 The final part of our QAPI guide, “Systematic Analysis and Systematic Action” discusses how to effectively diagnose problems, implement formulated solutions and maintain sustainable improvements. Your agency should efficiently coordinate all QAPI elements, then draw out concrete protocols mainly concerning organization and delivery of care services. We listed some…
Published: Mar 8, 2017 | 17:25 Part 4 in our 5-part QAPI guide, “Performance Improvement Projects” (PIP) is a focused course of action used to address specific problem areas. This is the part where data is put into action. Let us walk you through some steps to help you tackle your first successful Performance Improvement…
Published: Feb 10, 2016 | 10:16 This past January 2017, CMS finalized and published its final ruling on the Medicare and Medicaid Conditions of Participation (CoP) for Home Health Agencies. Slated to take effect on July 13 of this year, the new ruling includes updates to the CoP requiring a sustainable QAPI program and…
Part 2 in our 5-part QAPI guide, “Governance and Leadership”, discusses the importance of a QAPI management team. This team of dedicated leaders shall oversee the QAPI program as planned in its design and scope. Clear work objectives should be set first, emphasizing patient safety and quality care while prioritizing patient rights and choices. This…