Helping to Protect the Home Health Industry
Providing oversight on regulations, government overreach, and financial operational fundamentals to improve financial outcomesValue-Based Purchasing vs Pay-for-Performance
Are they the same thing? There is a misunderstanding in the home health industry that the Value-Based Purchasing Demonstration is in fact Pay-for-Performance; albeit under a different title. Well, that perception is incorrect. The Value-Based Purchasing Demonstration...
A Rare Face-to-Face Opportunity – in the Federal Register of July 29, 2016
Take advantage of this rare opportunity and participate in the Rule-Making-Process: Submit Comments In today’s Fed’l Register CMS has once again given the home health industry an opportunity to submit comments about the Face-to-Face (F2F) regulation; particularly in...
The Prior Authorization Requirement for Home Health
On Feb 5, 2016, CMS proposed a new regulation to establish a Prior Authorization Requirement for Home Health services provided in 5 select states: Florida, Texas, Illinois, Michigan, and Massachusetts The following was extracted from that notice: Type of...
Prior Authorization Requirement – Comments Submitted
Following is a copy of the comments that I submitted regarding the CMS proposal of establishing a Prior Authorization Requirement for all home health services in the five states noted (FL, TX, IL, MI & MA). I give anyone/everyone free rights to use my comments...
The HH PPS FINAL Rule for 2016 is available
CMS has issued the pre-publication version of: CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements today (10/29/15) at 4:15 pm. This is available at the Federal Register...
Financial Fundamentals in Home Health
Financial Fundamentals in Home Health: where have they gone? Financial Fundamentals in Home Health have greatly deteriorated since the inception of PPS. To succeed, HHAs will have to re-introduce them to their operations. Most HHAs do have some level of financial...
Analyses of the 2016 PPS Payment Rates
With the publication of the Proposed Rule for CY 2016, back on July 10, 2015, the information necessary for calculating the changes in the 2016 PPS Payment Rates has been available. There's a lot going on in this rule, but it ultimately boils down to reimbursement:...
Changes in Wage-Indices for CY 2016
Changes in Wage-Indices for CY 2016: After the transitional period of the Service Areas/Wage-Indices (only applicable to 2015) there are now going to be 509 distinct Service Areas, each with their own Wage-Index (there were 445 services areas in 2014). Every year I do...
The change in the Point Scoring Variables per the Proposed Rule
Once again, CMS is proposing to change the Point Scoring Variables of the OASIS for 2016. This is an issue that I do have some concerns about, but as a financial person that is not clinically trained I do not feel that I am able to understand and address with the...
2016 HH PPS Payment Rates are Projected to Decline Again
As we get ready to enter Year 3 of Rebasing, the 2016 HH PPS payment rates are projected to decline again. CMS notes in the Proposed Rule for 2016, that HH reimbursement is projected to be reduced another $350 million (a 1.8% reduction) as compared to total HH...