Essential Training At Your Finger Tips

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The session will focus on understanding emergency management and what home care providers need to know to be prepared. Due to the COVID-19 Public Health Emergency of the past two years, regulatory changes have been introduced that impact your agency's Comprehensive Emergency Preparedness Plan (CEMP). Lisa McClammy, Senior Clinical Education Consultant with MAC Legacy, will go over the requirements and implementation of your CEMP, which includes policies and procedures, risk assessments, communication plans, training and testing, drills, and documentation of your activities. As part of the discussion, we will also explore the "all-hazards" approach to risk assessment as it relates to emerging infectious diseases (EIDs) and recommended best practices in the interpretive guidelines. Read More

"With the implementation of the Patient-Driven Groupings Model (PDGM) in 2020, providers have had to adapt to the new system's incentive to maximize efficiency while maintaining a high quality of care. In their pursuit of efficient, quality care delivery under the PDGM, the most pressing challenges providers have encountered have been adjusting to the two 30-day payment periods within each 60-day episode, as well as navigating the fluctuating LUPA (Low Utilization Payment Adjustment) thresholds of 2-6 visits per each of the two 30-day periods. The Centers for Medicare & Medicaid Services (CMS) threw another curveball at providers with the publication of the 2022 Home Health Final Rule, which calls for nationwide implementation of Home Health Value-Based Purchasing (HHVBP) in 2023. The HHVBP further emphasizes the importance of efficient, quality-based care delivery. In this session, we will explore utilization and LUPA trends identified in CMS claims data, strategies implemented by Sutter Care at Home and McBee to mitigate avoidable LUPA and enhance quality care delivery, and identify best practice recommendations for success under a value-based care delivery model." Read More

The growth of internet-based marketing has caused some home care providers to lose sight of the need to personalize their marketing efforts. Patients/clients receiving care at home are so accustomed to receiving high-level service, and they want to maintain a personal relationship with the agency providing the care. Home care agencies need to adopt marketing strategies at the grassroots level, and this presentation explains how to leverage community-based initiatives that will plant the seed for future growth. The best part is that grassroots programs are usually free or very inexpensive, you only have to invest your time! Read More

Explore why strategic process improvements are essential during times of change. With the impacts of the pandemic on your organization’s culture, morale, recruitment, retention, and financial outcomes - all combined with the everchanging healthcare regulatory and reimbursement landscape - the future can look daunting. The impacts of the national roll out of value-based purchasing (VBP), the sustained growth of Medicare Advantage (MA), the reduction of Medicare Fee-For-Service (FFS), and the recent addition of the Value-based Insurance Deign Model (VBID) can be tamed through the effective use of the strategic process improvements. In this session you will get perspectives on how the strategic process works, how it can prepare you for these changes and the ones to come, but, most of all, how to roll these initiatives out to your staff to assure your agency thrives given the stresses of the operating environment today along with the rise of these transformational reimbursement models. Read More

"Despite the COVID-19 public health emergency and the full resumption of the Medicare Review Choice Demonstration (RCD), medical review activities have been fully resumed. The triggering of a medical review poses an additional challenge to agency operations. Aside from the RCD, multiple Medicare, Medicare Advantage, and commercial insurance reviewers examine medical records for accuracy, including those that are newly billed and reopened claims. It is common for home health agencies to focus on survey compliance rather than reviewing their medical records from a compliance and payment perspective. Medical reviews, audits, or probes can pose great difficulties if you are selected to undergo one of these processes. Compliant clinical records are the key to success, whether it is through the RCD, the Unified Program Integrity Contractor (UPIC), the Recovery Audit Contractor (RAC), the Supplemental Medical Review Contractor (SMRC), or Comprehensive Error Rate Testing (CERT). The required rules and regulations should be incorporated into the content at the time of creation, not later. The presentation begins by outlining key coverage requirements from Medicare regulations and what they actually require. It then provides examples of how to reflect these in the home health record to address known denial reasons. These include both nursing and therapy medical necessity requirements. In linking what is actually needed with known denial reasons, it shows how proper documentation can prevent negative outcomes. This also applies to the RCD when the full record is not reviewed in pre-claim review or when it is reviewed under an Additional Documentation Request (ADR) option. This session provides a solid foundation for educating your staff to prevent future denials and audits. Your current staff can learn how to chart correctly, while new staff can learn from the actual regulations to start off right. The topics covered in this session can also be applied to Medicare Advantage medical reviews that are not subject to the RCD." Read More

With the onset of the Patient-Driven Groupings Model (PDGM) during the pandemic era, many home health providers have failed to address the operational changes required to manage rehab under the new value-based model. As a result of the PDGM removing rehab visits from the payment calculation, many agencies have struggled with changes required to manage rehab content and outcomes. Recent work with multiple home health providers since the onset of the PDGM has revealed the connection between PDGM-compliant rehab programs, 5-Star Ratings, and optimal reimbursement. During this four-part webinar series, attendees will learn how Medicare positioned rehab management at the center of the PDGM despite removing per/visit therapy payments. Discover how to utilize the FIL (Functional Impairment Level) successfully to deliver value-based rehab programs based on the content modifications required for PDGM outcome success. In that manner, providers can develop the OASIS accuracy necessary for optimal reimbursement, while simultaneously establishing the care pathways required for 5-Star Ratings, single-digit readmissions, and optimal fiscal margins. This exciting series breaks down the Medicare approach to the PDGM’s development to assure an understanding of rehab changes and how to achieve compliance with your therapy staff and programs. Beginning with a 10,000-foot view of the hidden value opportunities in the PDGM’s rehab regulations, home health administrators, managers and supervisors will gain insight into how to rewire therapy for new levels of success. In subsequent presentations, the development of PDGM-compliant rehab plans of care (POCs) and visit content can assure a value-based therapy episode. Finally, required rehab content necessary for skill, and denials occurring under the PDGM will round out where we are today in terms of qualified therapy expectations. The series concludes with a summary of the PDGM’s rehab POC development and in-episode delivery from admission to discharge, with a nod to future IMPACT Act reforms that will modify rehab even more. Don’t miss the exciting and informative series to optimize your rehab programs for PDGM success.   Speaker/Course Author - Arnie Cisneros, PT  Read More

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