The Centers for Medicare and Medicaid Services (CMS) released their annual Hospice Wage and Payment Rate proposed rule for FY 2022 in the Federal Register on April 14 and there was plenty of updates regarding the HQRP. Many were expected but the one I found noteworthy is the addition of public reporting for a new CAHPS Hospice Survey Star Rating.

Occupancy and staffing are the two main issues facing SNFs today, both exacerbated by the unique effects of COVID-19 this past year. SNFs will need to get creative in solving these issues and adopting the right software and analytics tools will be critical. IntelliLogix™ by SHP can help facilities increase referrals, maximize reimbursement and save valuable time.

SHP is excited to be supporting the National Healthcare at Home 2021 Best Practices and Future Insights Study. Expected to be the most comprehensive study on the delivery of care at home to date, results will include best practices on the topics of staffing, reimbursement, new care delivery models, palliative care, and more. In order for the study to succeed we need your participation!

McKnight’s Long-Term Care News has announced it’s 2021 class of Rising Stars and Veteran VIP award recipients. We applaud all of the women awarded this honor, many of whom are customers of ours.

Effective April 1st 2020, CMS embraced the new ICD-10 code (U07.1) by adding it to the MMTA-Respiratory Clinical Group to reimburse home health agencies for these patients. I was curious to see how the PDGM model aligned specifically to these patients. Read more to see how frequently COVID-19 was utilized as a primary diagnosis code in Medicare PDGM 30-day period starts, and how COVID-19 patients compare to the SHP national database in regards to Comorbidity Adjustments and Functional Impairment. Also a look at Source and Timing attributes of COVID-19 stays, along with case-mix weights, and LUPA rates.

CMS published the CY 2021 Home Health Payment System Rate final rule on November 4th. As it stands, all of the PDGM methodology, the Behavioral Adjustments level, LUPA thresholds and case-mix weights will be kept the same in CY 2021 as they were in the first year of PDGM. With another quarter of data under our belts and with the better understanding and management of COVID-19, Chris Attaya takes a look at several areas of expected PDGM behavioral changes.

The advent of the Patient Driven Payment Model (PDPM) significantly expanded the Minimum Data Set (MDS) items that impact reimbursement and moved the focus from therapy minutes and ADLs to clinical diagnoses and resident characteristics. Now, more than a year post-implementation, there appears to still be significant opportunity to improve coding accuracy in areas that drive payment.

CMS recently announced some changes that will be implemented in the Hospice Quality Reporting Program (HQRP). For one, they are proposing to replace the Hospice Visits when Death is Imminent Measure Pair (HVWDII) with one new claims-based measure, Hospice Visits in the Last Days of Life (HDVDL). Another big announcement is that after the November 2020 refresh, Hospice Compare data will be frozen until February 2022. Hospices will need access to real-time quality scores to guide and enhance their quality improvement programs.

CMS recently announced that data displayed on the Home Health Compare (HHC) website will remain the same until January of 2022. That does not mean Home Health agencies should get complacent however. Performance now will affect future scores. In order to manage quality scores, home health agencies and hospices need access to real-time scores to guide and enhance their quality improvement programs.

CMS has announced that routine inspections for all Medicare- and Medicaid-certified providers and suppliers will soon resume, after suspending them as part of its response to the COVID-19 pandemic in March. Our Survey Risk Report can address risk indicators by ranking facilities that may be prioritized for survey based on the criteria.