HCAF: Maintaining Success at the Cross Section of Finance and Regulation (SN, OT, ST - 1.5 ACCT - 1.5 TB)

Since the implementation of PDGM, home health providers have faced many regulatory and financial challenges. Providers’ ability to maintain adequate revenue while meeting new and changing regulatory requirements and navigating ongoing reductions in CMS reimbursement is top of mind. The good news? There’s an opportunity to turn these regulatory and financial challenges into achievements. By dedicating time and effort to regulatory changes that impact revenue, care organizations can maintain control of their financial future.

A few of the key drivers for improving home health providers’ financial performance include: A) Increasing the number of 30-day periods per patient (Periods per Episode), B) Increasing recertification rate and C) Mitigating avoidable LUPA.  Some providers, however, have responded to increasing ADR and TPE audits by limiting the number of 30-day periods per patient, reducing the volume of recertifications and, consequently, increasing the number of avoidable LUPA within their organization. This presentation will delve into clinical documentation best practices to support reasonable and necessary skilled care, reduce the risk of audit denials, and allow providers to focus on those key drivers for improving financial performance.

Speakers/Course Authors - Carissa McKenna & Arrica Canty