Face-to-Face Issues, Investigation into Large Providers Dominate NAHC Discussions

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Homecare documentation

Events like the National Association for Home Care & Hospice’s annual meeting and expo provide terrific opportunities to see new products and learn how to operate your agency more efficiently.

But while speaking to attendees, I was reminded that conferences also are great places to swap notes with peers to discover the challenges and opportunities agencies are dealing with as well as what’s working and what isn’t to solve these challenges.

One of the most-talked-about issues concerned the new face-to-face encounter and problems with getting the necessary paperwork submitted in a timely fashion. Agencies are resorting to physically taking forms that require signatures over to doctors’ offices and paying premiums to clinicians for submitting all documentation in a timely fashion.

Documenting the face-to-face encounter
is yet another hurdle home health and hospice agencies have to overcome to get paid. Any slowing of revenue collection adds insult to the 5.5% decrease in home health reimbursement rates for 2011 and another expected 3.5% cut for 2012.

Agency executives also were lamenting the negative findings by the Senate Finance Committee against three large providers that have been accused of piling on profitable therapy visits while downplaying less profitable services to maximize reimbursements.

These accusations give the whole industry a black eye at a time when healthcare delivery already is under heavy scrutiny. Patients who have the best outcomes and the greatest satisfaction usually have higher OASIS evaluations, resulting in more services, according to Mark Sharp from BKD.

The key is to optimize services to return the patient to health or a maintenance state as efficiently as possible. Perform too many services, and you may be accused of fraud and face an excruciating federal audit. Underscore the patient and perform too few services, and patients could be rehospitalized, which undermines your credibility with referring partners who themselves are facing increased scrutiny to perform at a higher level.

But we all know the benefits that home health and hospice bring to patients, well beyond the reimbursement rates we receive. And that’s the story we should continue to tell to our referring partners, to our state and federal lawmakers and to the public.

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