CMS Proposes Changes to HH Quality Reporting Program

Proposed Changes Could Result in Another Revision to OASIS in 2021! How will this impact you? HCA is looking for your input.

CMS is proposing several changes to the Home Health Quality Reporting Program (HHQRP) in the CY 2020 Home Health Proposed Rule.

The Rule proposes to eliminate one measure (OASIS Item M1242, Frequency of Pain Interfering with Patient’s Activity of Movement), add two new measures, and add several new Standardized Patient Assessment Data Elements (SPADEs) to the Outcome and Assessment Information Set (OASIS) in CY 2021. The revised OASIS for 2021 will be very different from the current OASIS data items collected by your clinical staff.

As required by the IMPACT Act, the proposed two new measures are:

    1. Transfer of Health Information to the Provider-Post-Acute Care (PAC)
    2. Transfer of Health Information to the Patient-Post-Acute Care (PAC)

These measures are designed to improve patient safety by ensuring that the patient’s medication list is accurate and complete at the time of transfer or discharge. These proposed measures also supposed to fulfill CMS’s strategic initiatives to promote effective communication and coordination of care, specifically in the Meaningful Use Initiative area of transfer of health information and operability.

In addition, CMS is proposing to adopt several standardized patient assessments (SPADEs) to the OASIS data set. CMS plans to implement three assessment screens for mental status, confusion/delirium, and mood. The special service, treatments, and intervention assessment require the agency to identify the services and treatment the patient is receiving and if they are taking any high-risk drugs. The assessment item for medical conditions and comorbidities checks for pain during specific activities and checks for hearing and vision impairments. Click click here to see the proposed Item Mockup for the “Transfer of Health” and the “SPADE”

According to the National Association of Home Care & Hospice (NAHC), the organization sees two possible approaches in addressing the proposed changes to the HH QRP.

    1. Recommend that CMS stagger the implementation of the assessment items over several HHQRP years. However, this would result in more iterations of the OASIS assessment tool, and any changes to the assessment tool carry its own burdens and costs; or
    2. Support the new assessment items with the condition that CMS issues a draft version of the revised OASIS data set no less than six months before the implementation date.

Please let the Alliance know how these changes will impact you.

Return to www.thinkhomecare.org.

Talking Home Care: Building (and Keeping) a Better Workforce with Technology

Pat Kelleher is joined by CareAcademy’s Helen Adeosun and HouseWorks’s Andrea Cohen to discuss tech solutions to the workforce issues challenging the home care industry.

Helen Adeosun, Andrea Cohen, and Pat Kelleher
Helen Adeosun, Andrea Cohen, and Pat Kelleher

For the 11th episode of the Talking Home Care podcast, we are joined by two home care leaders to talk about solutions to one of the industry’s biggest challenges: recruiting, educating, and retaining care givers in a competitive market.

Helen Adeosun and Andrea Cohen both started their careers in home care as caregivers. Later, Helen would launch CareAcademy, an online learning platform, while Andrea would found HouseWorks, one of the largest private pay home care agencies in Massachusetts. In addition to their personal insights on workforce issues, the two also discuss their companies’ recent collaboration.

(If you’re a return listener from iTunes, please re-subscribe to the podcast; we’ve moved the feed to a new location).

Listen on iTunes
Listen on Google Play Music

 

You may listen to the podcast by clicking either of the podcast images, clicking “play” above, or downloading it directly (Length: 39 minutes; Size: 31 MB). If you enjoy the podcast, please give us a five-star review so others can find it.

Specific topics include:

    • How agencies can attract and keep their best employees by offering a career path to all positions.
    • How a mobile education platform can serve a mobile workforce.
    • How online education streamlines on-boarding and makes time available for hands-on training.
    • How technology — whether for training or other purposes — can give agencies actionable data about their operations.

Host: Patricia Kelleher is the executive director of the Home Care Alliance of Massachusetts.

GuestsHelen Adeosun is the co-founder and CEO of CareAcademy. Based in Boston, CareAcademy is one of the most innovative online training platforms for the home care industry. Andrea Cohen is the CEO and founder of HouseWorks, one of the largest private care home care agencies in Massachusetts.

Return to www.thinkhomecare.org.

Patient Legal Advocates

Information for clients/patients needing legal assistance around lost benefits or insurance.

The movement of many insured into “managed” environments has resulted in some questions to the HCA of MA regarding clients’ rights should home care services be terminated or suspended. Every Managed Care Organization (MCO) or Accountable Care Organization (ACO) – be they serving Medicare or Medicaid clients – has an obligation to have some form of patient (although not necessarily agency) internal appeal process. Agencies who are working with these organization should be versed in what these processes are.

For clients for whom the changes are threatening their well being, or seemingly discriminatory, or based on a pattern of inappropriate clinical decision making, there are legal services entities in this state who may be able to help. This list includes their names and contact information. Please note: these legal services entities will generally only take up a case if a client or, in some cases, a family member of a client calls. Keep this information on hand and share with any client who may need assistance.

Return to www.thinkhomecare.org.

HCA of MA Has Got You Covered for PDGM Education

HCA of MA is providing 4 unique opportunities at free or discounted rates to learn comprehensive elements of the new Medicare Patient-Driven Groupings Model (PDGM) being introduced this January.

HCA of MA is providing 4 unique opportunities at free or discounted rates to learn comprehensive elements of the new Medicare Patient-Driven Groupings Model (PDGM) being introduced this January.

PDGM: 4-Part Preparedness Series: August 6, 7, 13, & 14
Online Webinar Series

Is your agency prepared for the all the changes that will come with PDGM? This 4-part webinar series with Melinda Gaboury will give you the essentials your agency will need to prepare for PDGM. This series will cover coding changes, OASIS integrity, financial structure changes,LUPA’s, changes revenue cycles, and more!
• August 6th – PDGM Structure and Financial Changes
• August 7th – PDGM Coding & OASIS Integrity
• August 13th – PDGM Operational Decision Necessities
• August 14th – PDGM Revenue Cycle Changes
Instructor: Melinda Gabourey, Healthcare Provider Solutions

REGISTRATION
HCA Members: $379/Line for Full Series
HCA Potential Members: $599/Line for Full Series

All webinars are recorded

2020 Home Health Final Rule: September 11
Online Webinar

The 2020 Home Health Proposed Rule will be a seismic change in home health care. Learn from experts in the industry to help
understand the propsed rule and its impacts. Topics will include a review of Medicare’s new payment rates for home health, changes in use of PT assistants, and informed feedback to provide to CMS by the comments deadline of September 9, 2019, and more!

REGISTRATION
HCA Members: FREE
HCA Potential Members: $99/Line

PDGM Bootcamp: September 24, 9:00-4:00
Methuen, MA

Home Health Care Clinical Managers/Supervisors of Clinical Services, Quality Management staff and Clinical Educators will play a key role in the successful implementation of the new Medicare Patient Driven Groupings payment Model (PDGM). In this interactive session, attendees will learn the four key elements of the PDGM scoring system: admission source and timing, clinical groupings, functional levels and comorbidities. Managers will leave with specific techniques for obtaining accurate information to support coding, scoring and billing. All, while using the least resources to produce the best outcomes. Areas covered include: optimizing complex care, episode utilization and case management, interdisciplinary teamwork, care coordination and collaboration. The session will also describe key PDGM measures and monitoring techniques to optimize efficiency, achieve success and prevent pitfalls.

REGISTRATION
HCA Members: $159/Person
HCA Potential Members: $399/Person

PDGM Education by the National Association for Home Care
Online Webinar Series/ Videos

In a partnership with the National Association for Home Care, we are pleased to extend a special NAHC discount on several PDGM educational offerings all members of HCA of MA!

PDGM Video
If you’re familiar with PDGM but aren’t sure what the first steps are, this 5 ½ hour introductory course is for you. Leading industry experts will equip you with what you need to know to about the most significant change to impact home health in decades.

Webinar Series
If you want a deeper understanding of PDGM and how certain components will affect your business, this seven-part series is what you’ve been looking for. These webinars will focus on all parts of your agency, including risk factors, documentation review, clinical management and more. If you can’t attend the live webinar, don’t worry each of them will be recorded and available on- demand. You and your staff will have unlimited access.

Learn more on all education and register at:
www.thinkhomecare.org/Education

Members Flock to HCA’s Quality Improvement Meeting

Lots of member interest in HCA’s July QI meeting to discuss medical record audits and upcoming proposed rule changes.

With the sundry of regulation changes in the home health industry over the past few months, the July 24th Quality Improvement (QI) meeting had over 45 members participating in-person and by phone. The numerous medical record audits plaguing the industry dominated the meeting’s discussion.

Multiple agencies have received letters from C2C Innovation Solutions informing them that some claims under appeal have been selected for potential reopening as part of the Medicare Appeals Demonstration. The C2C auditors are conducting the analysis of claims previously adjudicated unfavorably by the Qualified Independent Contractor (QIC), that are currently pending at the Office of Medicare Hearings and Appeals (OMHA) and may be resolved favorably by the QIC.

Other audits that agencies are experiencing are new Targeted Probe and Educate (TPE) audits. These medical record requests are for 5-7 visits and lengths of stay greater than 90 days. No agency is in the third round of the Face-to Face TPE.

One agency reported at the meeting that they are facing three audits simultaneously; a hospice General Inpatient care (GIP) Targeted Probe from NGS, a home health PERM request for Face-to-Face (awaiting ALJ) and eight GIP Post Payment Review by Noridian.

During the meeting there was a lot of member engagement related the 2020 Proposed Rule; the proposal to require OASIS for all payors and the 8% behavioral adjustment. Agencies also discussed strategies for management with PDGM and the process for completing OASIS B-1 for January 1st episodes. PDGM will be a standing QI agenda item.

The HCA is planning to host a PDGM Networking Meeting to help our members with the transition to this new payment model. We are hoping to begin the meetings in September and have a guest speakers and consultants to assist with planning for this historic payment change. Stay tune for further details.

Don’t forget to check out our PDGM Bootcamp on September 24th!

New PDGM Bootcamp Announced!

HCA of MA has introduced a new full day training on PDGM for Clinical Managers/Supervisors and Quality Management Staff.
https://www.thinkhomecare.org/resource/resmgr/event_forms/PDGM_Bootcamp_Flyer_and_Reg.pdf

Home Health Care Clinical Managers/Supervisors of Clinical Services, Quality Management staff and Clinical Educators will play a key role in the successful implementation of the new Medicare Patient Driven Groupings payment Model (PDGM). In this interactive session, attendees will learn the four key elements of the PDGM scoring system: admission source and timing, clinical groupings, functional levels and comorbidities. Managers will leave with specific techniques for obtaining accurate information
to support coding, scoring and billing. All, while using the least resources to produce the best outcomes.

Areas covered include: optimizing complex care, episode utilization and case management, interdisciplinary teamwork, care coordination and collaboration. The session will also describe key PDGM measures and
monitoring techniques to optimize efficiency, achieve success and prevent pitfalls.

PROGRAM OBJECTIVES (At the completion of this session, participants will be able to….)

  • Describe key elements of Medicare’s PDGM payment model
  • Explain the impact of the new regulations on clinical operations and clinical managers
  • Identify key clinical operations changes that will be required for PDGM success
  • Create an initial action plan for successful PDGM implementation

ABOUT THE SPEAKER: Barbara Katz, RN, MSN is an experienced clinician, manager, trainer and health care consultant. Barbara has been a hospital registered nurse, an APRN in internal medicine, a site manager for a Kellogg Foundation self-care education grant, a training manager and a manager of clinical operations for a network of medical practices. She has been Vice President for Clinical Program Development in a large home health care agency where she founded a family caregiver support network.
Barbara provides training in leadership for value based payment, patient self-management support, family caregiver support, process improvement tools and techniques, population health strategies, the use of data
in daily work, communication, teamwork and motivational interviewing.

REGISTRATION:
Members: $159/Person
Non-Members: $399/Person

Or Download the Registration Form Here

“To get others to be involved: This conference was an eye opener to areas we need to improve upon and the tools provided will help in the process. This really brings it all together and a better understanding of PDGM.”

“This was excellent very informative. Made PDGM clear & understandable. Great tips to get started & to stay on task. Barb is a great presenter & her use of handouts was helpful.”

Annual Report – Message from our President

Annual Report: Message from the President of HCA of MA

Last month HCA of MA published our Annual Report to members.  Below is the opening message from our President.

To the Members:

“The world is changed by your example, not by your opinion.”

This year HCA of MA is celebrating 50 years as a membership driven trade association advocating with and on behalf of home care agencies, and home care patients.

It is very humbling to be Board Chair during such a milestone year. As many Board chairs before me have done, I have learned from the example set by those that have come before me, that includes both my immediate predecessors, such as Holly Chaffee and Wayne Regan, and those that came before them.  They all instinctively knew that you can’t ask of others what you are unwilling to do yourself and that waiting around for somebody else to do it is a sure way to assure that nobody does it.

As I look back at the year as laid out in this report, I see so much that we can be proud of as a member dedicated organization.  As President for a second term, I will work hard to make sure that continues. As our diverse members – each in their own way – struggles with the human resource, funding, marketing/image and regulatory issues, I want us not to lose site of some very big picture indisputable facts, including:

  • The demographics of our aging population will continue to demand new and more creative approaches to chronic care, serious illness and population health management and home care is the industry to provide these,
  • Home Care is where the professional and paraprofessional health care jobs will be increasingly moving to, and
  • All indications are that patients and families want and are satisfied with the services our member agencies provide.

When we lead by example and build on these certainties, we cannot help but be successful.

Thank you for your confidence.

Maureen Bannan
President