Specialists to help your organization adapt and succeed under healthcare reform
There are vast changes coming to health care as the nation struggles to improve access and outcomes while at the same time bring down the cost. By 2019, through a complicated formula of caps, rebasing, and reductions, home healthcare agencies will see $37.9 billion in Medicare cuts, and hospice payments will be reduced by $7.8 billion.
For its part in the solution, the government is establishing programs to test new patient care models. Many of them focus on leveraging home health and hospice to successfully transition patients from more expensive hospital care. One program bundles services among the hospital, the physician group, the skilled nursing facility, and home health. Another offers financial incentives to states that increase their spending on noninstitutional long-term care services.
There is also a move toward value-based purchasing. Medicare will be paying for quality and expecting qualitative outcome measurements to prove it. In other words, Medicare is expecting home health and hospice agencies to become more efficient and be able to document the effectiveness of their care.
This sounds complicated, but there are also many opportunities. Plante Moran’s veterans in home health and hospice can help you develop a strategy for leveraging these opportunities. Whether it means looking for a merger partner or being named a preferred provider for a hospital, they will support you with data and guidance to make the best decisions for your organization.
The following is a list of services:
- Chart to bill review of services for accuracy & appropriateness
- Annual cost reports
- Financial performance improvement
- Tax preparation & financial statements
- Agency start-up & accreditation services
- Due diligence for mergers & acquisitions
- Business valuation
- OASIS assessment review for plan of care accuracy, reimbursement opportunities, & recommendations for performance improvement
- Quality assurance/Performance improvement program review to assess patient outcomes & adherence to regulation
- Compliance review of medical records for services provided, medical necessity, & program adherence
- Identification of risks & development of a Corrective Action Plan (CAP)
Compliance Program Consulting:
- Annual compliance program review and/or program development
- Additional Document Request (ADR) review & recommendation
- Survey and/or accreditation Corrective Action Plan (CAP)
- Mock federal, state, & accreditation survey
Administration and Human Resources:
- Operations assessment of program efficiency
- Productivity & staffing analysis
- Personnel record compliance review
- Educational services for clinical & non-clinical employees