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The Medicare Review Choice Demonstration (RCD) begins in Florida on May 4, 2020, coinciding with the novel coronavirus (COVID-19) outbreak and the new Patient-Driven Groupings Model (PDGM) payment overhaul. Prepare now for RCD success with a webinar presentation by Palmetto GBA for home health providers that will review the basics of this five-state demonstration. This presentation will demonstrate how providers can select the review choice option through Palmetto GBA's online eServices portal during the 30-day window, March 20 through April 19. Additionally, lessons learned from the RCD in Illinois, Ohio, and Texas will be examined. Don't miss this opportunity to hear directly from your Medicare Administrative Contractor and get answers to your questions before the May 4th implementation.  Course Author: Cara Mia Wilkins, Charles Canaan, Dan George, Elizabeth Brogdon  Read More

Florida is one of dozens of states to declare a public health emergency as increasing cases of COVID-19 are being reported across the nation. As the novel coronavirus spreads, its outbreak is posing a particular challenge for home health providers. Those most vulnerable to the infectious disease include the elderly and those with pre-existing medical conditions such as asthma, COPD, similar respiratory conditions, diabetes, and heart disease — all common among homebound patients. Recent events, including the State of Florida's emergency order to impose temporary restrictions for all individuals entering residential and long-term care facilities, probably have you wondering what to do and what are some next steps to prepare your staff and patients. Plan to join HCAF on Thursday, March 19 at 12:00 ET for an hour-long briefing to get up to speed on the latest information on COVID-19 and its implications for home health providers while learning about practical, real-world solutions for possible scenarios specific to the in-home setting.  Course Author: J'non Griffin Read More

Home health providers are nearly two months into the “Volume to Value” transition marked by the installation of the Centers for Medicare & Medicaid Services (CMS) Patient-Driven Groupings Model (PDGM). Adapting to the new care production and delivery model presents challenges for the entire agency as traditional home care protocols will fail to produce the desired outcomes. As a result, all departments must be included in a successful PDGM value transition. Addressing intake and scheduling concerns are just the first steps to value outcomes, as they set the stage for an efficient clinical episode. Rewiring start of care OASIS admissions for accuracy in clinical profile deliver data for value-based plan of care production, identifying an initial care path to be managed on an in-episode basis for skill and value by quality assurance and utilization review personnel. By addressing the Low Utilization Payment Adjustment (LUPA) and Not Taken Under Care (NTUC) through compliance with CMS home health regulations, missed visits for value compromise, and patient scripting for outcomes and satisfaction, providers rewire areas that must be addressed for optimal outcomes. This webinar will present initial PDGM results from providers seeking optimal outcomes through assertive management of the value areas listed above. Focusing on the basics of the IMPACT Act’s “Volume to Value” philosophy, they have seen promising clinical and fiscal results of early PDGM episodes. By assuming care responsibility of value elements of the Medicare model, they have been able to reduce clinical staff stress while managing programs successfully with an in-agency model. Value results in case-mix, plan of care costs and management, clinical outcomes have all improved, and significant gains have been seen in missed visits and timely documentation for coverage. Don’t miss this progressive webinar to learn about initial clinical and financial results being posted during the PDGM “Volume to Value” transition.   Course Author: Arnie Cisneros, PT  Read More

The PDGM brings many changes to the billing process, including doubling 75% of the volume of claims for current Medicare episodes compared to 2019 that will be sent, as well as multiple changes to claims data. With RAPs (Requests for Anticipated Payment) and final claims now required every 30 days instead of 60 days, agencies may need to expand their revenue cycle teams. This webinar will cover details regarding the actual billing changes that will need to occur under the PDGM. We will take you through the details of billing under the PDGM and will review the process that the Medicare Administrative Contractor will go through to calculate the HIPPS code and pay claims. Lastly, this webinar will cover the proposed changes from a RAP to NOA (Notice of Admission) for 2021. There will also be a discussion of the overall impact on the revenue cycle under the PDGM. Course Author: Melinda Gaboury Read More

The Patient Driven Groupings Model (PDGM) became effective on January 1, 2020. This is the most significant change to the home health care industry reimbursement structure since the introduction of the current Prospective Payment System (PPS) in October 2000. The new payment model dramatically impacts agency operations, processes and performance. Home health agencies must develop and implement plans to successfully transition to the PDGM now. This webinar presentation will review key areas, strategies, and processes in preparing an agency for the PDGM. The speaker will focus on the changes to the 30-day payment model, which will bring significant back office changes, specific to the claims processing and collections.  Course Author: Melinda Gaboury Read More

For millions of seniors, long term care insurance is an integral part of their long term care plans. This presents a unique opportunity for home health providers. Providers well-versed in the nuances of long term care insurance can market to and better attract these types of clients. However, long term care insurance is nuanced and complicated and mistakes can end up being costly. Join us as we welcome Paradigm Senior Services' Steven Dunn and learn how to capture this particular market. Read More

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