PEPPER Report to Show Insight into Hospice Agencies

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By Terry Miller, RN 
Regulatory Advisor, McKesson

Hospice Agency Pepper ReportsIf your hospice agency is associated with a healthcare system, you might have heard of the acronym PEPPER. But if you haven’t, you will later this month.

That’s when CMS will be sending out the first PEPPER reports, which will include hospice-specific statistics for Medicare services that may be at risk for improper payments. PEPPER stands for Program for Evaluating Payment Patterns Electronic Report, a version of which has been provided to hospitals for years.

The report will focus on live discharge ranges and long lengths of stay. Hospice agencies with measures on either of those criteria above the 80th percentile are considered at risk for improper Medicare payments. Agencies will be able to compare their scores with other hospice agencies in their state, in their MAC jurisdiction and across the country.

Your report should arrive this month via FedEx and be addressed to your CEO. As soon as you receive it, be sure to look at your scores and how you compare with peers. Those with management systems should be able to review their internal information easily to get a better picture of how their scores were generated.

But simply examining the data is not enough. You should use this information to support your internal monitoring efforts. CMS wants to help agencies stay in compliance, and this report can help agencies self-monitor.

To assist your efforts, a number of resources are available. The hospice PEPPER report was developed by CMS contractor TMF Health Quality Institute, which has prepared a resource guide to help agencies understand how to interpret and use this data. Registration will open soon for a web training session on Thursday, Sept. 13 at 2 p.m. ET. The training session will be recorded and posted on PEPPERresources.org in the Hospice “Training & Resources” section.

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