Join us on Tuesday, December 10th at the Beechwood Hotel in Worcester, MA for our Annual Financial Management Conference. Take a deep dive into the current trends and issues happening in the Home Health industry as you prepare for 2020.
Join us on Tuesday, December 10th at the Beechwood Hotel in Worcester, MA for our Annual Financial Management Conference. Take a deep dive into the current trends and issues happening in the Home Health industry as you prepare for 2020. This is the perfect conference for CFOs, CEOs, and Clinical Directors!
The 2019 Agenda Includes: Hindsight is 2020: Hone into Home Health & Hospice Payment Compliance in the New Decade, Kathleen Hessler, Simione Healthcare Consultants The HHS Office of Inspector General (OIG) continues its intense oversight and scrutiny of the Medicare home health and hospice programs by analyzing the rich sources of data available to them. With increase in survey and audit activity —including Targeted Probe and Educate (TPE), UPIC and SMRC audits, learn what your agencies need to do to ensure payment compliance in the new decade. The session will cover types of government audits, recommendations for internal-self monitoring, as well as what to do if your agency identifies an overpayment.
HHVBP Trends & Data, Chris Attaya, SHP Data As we close out year 2 of the Home Health Value-Based Purchasing Demonstration, Chris Attaya will take a deep dive and identify the latest updates and trends in HHVBP and Star Rating measure scores. Attaya will also discuss data points specific for Massachusetts state agencies.
PDGM Check Point, Mike Carr, Axxess PDGM is almost here, now is the time to ensure you are ready for the changes. This session will review where you should be, and how to get there if you’re not. Carr will provide a high level overview of PDGM as well as understanding how past performance will be impacted by PDGM. Other elements to be discussed include technology challenges, therapy impact, and measures for survival.
Making Home the Center of Care: Opportunities & Challenges of Public Priorities, Mike Canter, Carecentrix & Reactor Panel Recent public policy trends focus on cost containment, integrated care, and quality outcomes. Home care is in a unique position to thrive in this emerging environment. Is your agency poised to seize the opportunity?
PDGM is coming January 1, 2020 – HCA has numerous education opportunities to help you prepare and progress!
Blueprint for OASIS Training & Certification, November 4-6 Training, Devens, MA
Experience the comprehensive and nationally acclaimed two-day Blueprint for OASIS Accuracy workshop and learn to confidently teach, audit, and collect OASIS-D items accurately. Through guided, expert instruction, and participation in problem-solving discussions and application scenarios, achieve mastery of the OASIS items, conventions, and the latest data collection rules. Rather than provide opinions, assumptions, or unfounded interpretations, the “Blueprint” presenters will model reliance on CMS guidance documents and provide and demonstrate strategies for how to find defendable answers to your OASIS questions.
PDGM Comittee Meeting, November 18 Networking Meeting, 10:00-12:00, Milford, MA
Clinical Leadership Development and Care Coordination Under PDGM
PDGM introduces complex challenges and heightens the importance of efficient discipline utilization while maintaining quality care outcomes. The role that the clinical manager plays in this care management process can make or break success under the new model. This session will cover strategies for effective collaboration of care and agency leadership development in order to maintain focus on patient-centered quality care delivery.
Registration: FREE HCA MEMBERS ONLY!!
PDGM Clinical Episode Management Webinar, November 21 Online Webinar, 2:00-3:30PM
Clinical episode management takes on an even more critical role under PDGM. This session will describe how effective clinical episode management is the foundation for improving both patient and agency outcomes as well as improving regulatory compliance. We will review tactics for management of the 30 day payment period and explain the new LUPA thresholds and show that effective clinical episode management will be key to ensure patients are receiving appropriate, cost-effective, quality care. We will discuss strategic planning for implementation of clinical episode management best practices within the agency, and strategies to enhance communication and collaboration between all disciplines.
PDGM is fast approaching and a lot of changes are coming with it. HCA has partnered with Melinda Gabourey, CEO of Healthcare Provider Solutions, to put on a 4-part webinar series, each 90-minutes long! The series will run daily from 11:00AM-12:30PM. Sessions include: • PDGM Structure & Financial Impact • PDGM Coding & OASIS Integrity • PDGM Operational Decision Necessities • PDGM Revenue Cycle Changes
REGISTRATION HCA Members: $79/Line per Webinar -OR – $299/Line for Full Series Non-Members: $149/Line per Webinar -OR – $549/Line for Full Series
2019 Financial Management Conference, December 10 Conference, Worcester, MA, 9:00AM-4:00PM
This years financial conference will cover topics on PDGM, VBP, Billing Compliance, and Managed Care. The following PDGM session will be by Mike Care of Axxess: PDGM is almost here, now is the time to ensure you are ready for the changes. This session will review where you should be, and how to get there if you’re not. Carr will provide a high level overview of PDGM as well as understanding how past performance will be impacted by PDGM. Other elements to be discussed include technology challenges, therapy impact, and measures for survival.
2020 Leadership Summit Pre-Conference, January 28 Conference, Boston, MA, 1:00-4:30PM
Vision Quest: Refining Your Personal Leadership Style for Success Under PDGM and After We will start the summit with an interactive exploration of what industry and leadership issues you are hear to work on! After breaking it all down, we will engage in some self reflection on your leadership journey to date and how that has or has not got your prepared to meet today’s challenges. The session will continue with an instructional tutorial that will help to make you a better more confident and ultimately successful leader. Put it all together with a set of top industry experts on the journey to PDGM success.
PDGM Impact on Therapy Practice, March 5 Online Webinar, 1:00-2:30PM
CMS has changed the PPS case mix system “to rely on patient characteristics to set payment for therapy and non-therapy services and should no longer use the number of therapy visits as a payment factor.” The practice patterns and therapy compensation creep associated with the PPS methodology up until 2020 will fit poorly with a case mix system not relying on a therapy visit number. However, practice pattern changes do not occur as abruptly as payment changes. This session will review the new Patient Driven Groupings Model (PDGM) and how therapy can and should impact the groupings within their own agency. We will then apply reasonable and necessary plans of care to typical home health conditions and link them to the outcomes agencies strive to achieve. Participants will learn to prepare changes in practice and to demonstrate the value therapy services can bring to the home health agency.
Staying on top of OASIS coding is never easy, and PDGM will bring additional challenges in 2020. Join us November 4-5, 2019 in Devens for an intensive, two-day, workshop & exam from OASIS Answers. Though open to all, Alliance members can attend at a significant discount.
Staying on top of OASIS coding is never easy but – with the new PDGM standards arriving in a few months – 2020 is going to be a real challenge.
That’s why we’re pleased to offer Blueprint for OASIS Accuracy, a two-day, data-collection workshop in Devens, Massachusetts on November 4-5, 2019.
This workshop — designed by OASIS Answers — provides a comprehensive look at the OASIS items including the OASIS-D1 revisions and OASIS-related PDGM information effective January 1, 2020. The course awards 13 CEUs. Attendees can also take an optional exam at the same location the following day (registration and payment for the exam is entirely separate from the workshop).
Though the program is available to all, members may attend for just $429.00 per registrant, a discount of $150 off the non-member rate. If you’ve been thinking about having the Alliance join, this will give you immediate return on your investment.
HCA will host an HR Management Half-Day Conference on Tuesday, October 29 at the College of the Holy Cross in Worcester, MA. This conference is an excellent resource for HR Managers, CEOs, COOs, and Clinical Directors.
HCA will host an HR Management Half-Day Conference on Tuesday, October 29 at the College of the Holy Cross in Worcester, MA. This conference is an excellent resource for HR Managers, CEOs, COOs, and Clinical Directors. Topics will include the following:
Attracting a Talented Workforce, Sheri Heller, PHR, SHRM-CP, Senior HR Advisor MassPay HR & Services Attracting and keeping talented employees in today’s job market is more difficult than ever. Learn about best practices to ensure successful talent acquisition efforts that will lead to a high-performing workforce. This session will include topics on talent sourcing vs. recruiting; finding the right talent pool; building your employer brand; the candidate experience; and creating the perfect job ad.
Discrimination Law Issues for the Home Care Industry, Layla Taylor, Esq. Partner, Sullivan Hayes & Quinn Employment discrimination laws have been established to prevent discrimination based on race, sex, sexual orientation, religion, national origin, physical disability, and age. Learn from Taylor the important key points relating to patient choice and anti-discrimination case law for your employees. Topics such as employee religious and disabiliaty accommodations to vaccinations will be covered.
The Step-by-Step HR Department Checklist, Julie Brinkman, COO, Hireology Whether you have a staff of 5 or 500, clear HR policies and consistent processes are essential to success on the people side of your business. This presentation will review a comprehensive HR checklist developed by Hireology and BambooHR designed to help home care agencies establish a new HR function or improve the HR systems and initiatives that are already in place in your agency. This checklist includes key elements such as an overview of important HR policies and processes, recruitment best practices to attract quality candidates, and tips for developing and maintaining a successful HR team.
Home Care Alliance Workforce Initiatives, HCA of MA Staff The HCA Board has identified Workforce Development as a critical priority issue under its current Strategic Plan. A Board working group had identified a number of initiatives for the Alliance and Foundation to expand our member support on workforce issues, addressing staff development at all levels: executive, management, supervisory, and all levels of direct care. This session will review results to date on some of the projects already in progress, preview future objectives, and solicit member input on new initiatives to help ensure a skilled and motivated workforce for the future.
Registration is only $50/Person for HCA of MA Members!
2019 Private Care Management Conference Agenda Announced!
Labor Management Relations, Robert Brooks, Labor & Employment Partner, Verrill Dana Learn strategies to develop an effective plan of action when dealing with the current labor laws. This session will review recent and ongoing developments relating to handling your employees; such as, hiring, firing, discipline, and payment of wages. Additionally, hear more on the new Massachusetts Home Care Worker Registry Act and how it impacts your organization.
Recruiting, Onboarding & Educating the Caregiver Workforce of the Future,Helen Adeosun, EdM, Co-Founder & CEO of CareAcademy Educating caregivers is the number one health intervention for today’s home care agency. Learn staffing best practices to help find new caregivers and educate existing caregivers to meet the growing needs of clients in their care. Attendees will learn several actionable steps that agency owners and management can take today to ensure that their caregivers have the knowledge they need that a structured training program can offer, and the positive impact for retention, home care ROI and business.
Preventing Verbal Abuse of Workers: The Safe Home Care Project,Margaret M. Quinn, ScD, CIH, Professor and Director, Safe Home Care Project, Zuckerberg College of Health Sciences, UMass Lowell Previous studies have found that violent behaviors, including verbal abuse as well as physical assault, by patients towards health care workers is common and leads to injuries, illness, burnout and job turnover. The Safe Home Care Project team conducted a survey of nearly 1,000 Massachusetts home care aides and found that about 1 in 4 experienced verbal abuse from clients within the past year. The study identified home care conditions under which verbal abuse was most likely to occur and recommendations for prevention that can improve safety for both aides and their clients.
Key Metrics to Motivate Staff, Improve Retention and Promote Growth, Kunu Kaushal, Senior Solutions Home Care Learn from the Senior Solutions Home Care founder and CEO Kunu Kaushal who grew his Tennessee-based home care business from zero to $18+ million in nine years, with 800+ clients and 10 locations. The first session will share actual usable metrics, and formulas to help operate your agency at peak performance. Areas covered will include financials, operations, staffing, and recruitment. Move beyond revenue metrics to incentivize staff and provide more clarity around roles related to scheduling, recruitment and human resources. This simple, budget-driven model uses national metrics and KPIs that consider salaries and profitability for setting goals, defining responsibilities and motivating your staff.
Building Your Leadership Team, Kunu Kaushal, Senior Solutions Home Care In the second session you will learn his culture “secrets”, what makes a company’s culture great, how employee engagement can impact that culture. Kunu will share how he managed to build an attractive work culture, recognize when it’s time to let someone go, how to manage accountability, and more. Additionally, Learn how a great leadership team is built, including how to identify when it’s time to add to the team, ways to divide roles in order to maximize the team’s efficiency and key skill sets to identify when hiring.
There are many ways that home health agencies will need to prepare their agencies for the radical changes coming from PDGM in January 2020. The Alliance is here to help.
Last month, the Centers for Medicare & Medicaid Services (CMS) issued its proposed rule for 2019 home health payment rates and policy changes, which includes significant provisions that will impact your organization, staff, and the patients you serve.
Between now and when the Patient Driven Grouping Model (PDGM) goes into effect on January 1, 2020, there are multiple ways that home health agencies will need to prepare their agencies for the radical change. (See Coding and Billing webinars coming in September, at the bottom of this page) At the same time, home care must take action to mitigate the impact of what PDGM will look like and how it will impact organizational viability.
Home care’s collective advocacy efforts have undeniably made a difference in the past, including putting a stop (at least in Massachusetts) to the Pre-Claim Review Demonstration and scrapping the Home Health Groupings Model thanks to more than 1,200 comments submitted to CMS last year. The more that CMS and lawmakers hear from home health professionals, the better our chances are at reducing the severe cuts that accompany PDGM in its proposed form.
As currently proposed, the 2020 rule will:
Reduce the Medicare base rate by 8.01% next year, which amounts to a $1.298 billion reduction in home health payments in 2020 alone. CMS proposes the reduction to account for anticipated changes in provider behavior that are unrelated to changes in patients served or services delivered that increase payments. This newly proposed “behavioral adjustment” reduction is up from the 6.42% reduction that CMS initially proposed, and the reduction would start before any actual behavioral changes occur.
Phasing out RAPS over 2020 with total elimination of RAPs in 2021. Next year, CMS proposed reducing RAPs from 60/50% to 20% for existing home health agencies (HHAs), while new agencies would get no RAP. CMS claims that RAPs create fraud risks.
Starting in 2021, a Notice of Admission (NOA) must be submitted Notice of Admission must be submitted within five days of the start of care. For every day late, CMS plans to reduce base-rate reimbursements for the unit of care.
The Solution: Pass S.433/H.R.2573
This month, Congress is in recess and back in the states, which presents a pivotal opportunity for home health industry professionals to engage with lawmakers about a key legislative priority – the Home Health Payment Innovation Act (S.433/H.R.2573).
This legislation prohibits CMS’s ability to adjust payment based on “behavioral assumptions” as opposed to observed evidence of behavioral changes, thus rescinding the proposed 8.01% adjustment.
Additionally, this important legislation would:
Achieve full budget neutrality over the period of 2020-2029.
Require behavioral adjustments based on real, actual changes in provider behavior in response to the new payment model.
Permit a phase-in of rate adjustments (up or down) when an annual adjustment would be greater than 2 percent. However, the phase-in would operate to ensure full budget neutrality by 2029.
Email your Members of Congress
It’s not too late to get members of Congress informed and engaged on this important legislation. You can send an email directly from HCA’s member advocacy center.
At this point, Congressman Jim McGovern is the only member of the MA delegation signed on as a cosponsor. We must do better.
Join home health industry advocates next month in Washington, D.C. for The Council of State Home Care Associations’ Third Annual Public Policy Summit and Advocacy Day! On September 9, participate in a full-day summit featuring speakers including Hillary Loeffler, Director of the CMS’ Division of Home Health & Hospice. On September 10, we be on Capitol Hill meeting with members of Congress to convey the critical need to pass S.433/H.R.2357.
Click here to submit comments to CMS in response to the 2020 proposed rule by 5:00 PM ET on Monday, September 9, 2019.
HCA and other industry organizations will provide more thorough comments on other problematic areas of the proposed rule. As previously stated, there is strength in numbers, so the more business-focused comments from providers – both large and small – are critical to giving CMS a full and clear picture of how devastating PDGM will be should it be implemented as proposed. Watch Update for draft comments.
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.