Showing posts tagged with: CDI

CoP Interpretive Guidelines: Are You Compliant?

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Clinical Documentation Improvement, Clinical Practices, Compliance, Conditions of Participation (CoPs), HIPPA

CoP Interpretive Guidelines: Are You Compliant?

Are You Compliant With CoP §484.60?

 
Home Health Agency Condition of participation (CoP) went into effect January 13, 2018 (CMS, 2018). However, some agencies are still struggling when it comes to Condition of participation (CoP). According to the CoP Interpretive Guidelines, to be compliant with CoP §484.60, home health agencies must have established standards of practice issued by a nationally recognized organization with expertise in the field. If your organization fails to meet these minimum standards when audited, you may be assessed a monetary fine or lose your Medicare certification.

§ 484.60 Condition of participation: Care planning, coordination of services, and quality of care.

Patients are accepted for treatment on the reasonable expectation that an HHA can meet the patient's medical, nursing, rehabilitative, and social needs in his or her place of residence. Each patient must receive an individualized written plan of care, including any revisions or additions. The individualized plan of care must specify the care and services necessary to meet the patient-specific needs as identified in the comprehensive assessment, including identification of the responsible discipline(s), and the measurable outcomes that the HHA anticipates will occur as a result of implementing and coordinating the plan of care. The individualized plan of care must also specify the patient and caregiver education and training. Services must be furnished in accordance with accepted standards of practice.

(a)Standard: Plan of care.

Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician is consulted to approve additions or modifications to the original plan.

(2) The individualized plan of care must include the following:

(i) All pertinent diagnoses;

(ii) The patient's mental, psychosocial, and cognitive status;

(iii) The types of services, supplies, and equipment required;

(iv) The frequency and duration of visits to be made;

(v) Prognosis;

(vi) Rehabilitation potential;

(vii) Functional limitations;

(viii) Activities permitted;

(ix) Nutritional requirements;

(x) All medications and treatments;

(xi) Safety measures to protect against injury;

(xii) A description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors.

(xiii) Patient and caregiver education and training to facilitate timely discharge;

(xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient;

(xv) Information related to any advanced directives; and

(xvi) Any additional items the HHA or physician may choose to include.

(3) All patient care orders, including verbal orders, must be recorded in the plan of care.

(b)Standard: Conformance with physician orders.

(1) Drugs, services, and treatments are administered only as ordered by a physician.

(2) Influenza and pneumococcal vaccines may be administered per agency policy developed in consultation with a physician, and after an assessment of the patient to determine for contraindications.

(3) Verbal orders must be accepted only by personnel authorized to do so by applicable state laws and regulations and by the HHA's internal policies.

(4) When services are provided on the basis of a physician's verbal orders, a nurse acting in accordance with state licensure requirements, or other qualified practitioner responsible for furnishing or supervising the ordered services, in accordance with state law and the HHA's policies, must document the orders in the patient's clinical record, and sign, date, and time the orders. Verbal orders must be authenticated and dated by the physician in accordance with applicable state laws and regulations, as well as the HHA's internal policies.

(c)Standard: Review and revision of the plan of care.

(1) The individualized plan of care must be reviewed and revised by the physician who is responsible for the home health plan of care and the HHA as frequently as the patient's condition or needs require, but no less frequently than once every 60 days, beginning with the start of care date. The HHA must promptly alert the relevant physician(s) to any changes in the patient's condition or needs that suggest that outcomes are not being achieved and/or that the plan of care should be altered.

(2) A revised plan of care must reflect current information from the patient's updated comprehensive assessment, and contain information concerning the patient's progress toward the measurable outcomes and goals identified by the HHA and patient in the plan of care.

(3) Revisions to the plan of care must be communicated as follows:

(i) Any revision to the plan of care due to a change in patient health status must be communicated to the patientrepresentative (if any), caregiver, and all physicians issuing orders for the HHA plan of care.

(ii) Any revisions related to plans for the patient's discharge must be communicated to the patientrepresentative, caregiver, all physicians issuing orders for the HHA plan of care, and the patient's primary care practitioner or other health care professional who will be responsible for providing care and services to the patient after discharge from the HHA (if any).

(d)Standard: Coordination of care. The HHA must:

(1) Assure communication with all physicians involved in the plan of care.

(2) Integrate orders from all physicians involved in the plan of care to assure the coordination of all services and interventions provided to the patient.

(3) Integrate services, whether services are provided directly or under arrangement, to assure the identification of patient needs and factors that could affect patient safety and treatment effectiveness and the coordination of care provided by all disciplines.

(4) Coordinate care delivery to meet the patient's needs, and involve the patientrepresentative (if any), and caregiver(s), as appropriate, in the coordination of care activities.

(5) Ensure that each patient, and his or her caregiver(s) where applicable, receive ongoing education and training provided by the u, as appropriate, regarding the care and services identified in the plan of care. The HHA must provide training, as necessary, to ensure a timely discharge.

(e)Standard: Written information to the patient. The HHA must provide the patient and caregiver with a copy of written instructions outlining:

(1) Visit schedule, including frequency of visits by HHA personnel and personnel acting on behalf of the HHA.

(2) Patient medication schedule/instructions, including: medication name, dosage and frequency and which medications will be administered by HHA personnel and personnel acting on behalf of the HHA.

(3) Any treatments to be administered by HHA personnel and personnel acting on behalf of the HHA, including therapy services.

(4) Any other pertinent instruction related to the patient's care and treatments that the HHA will provide, specific to the patient's care needs.

(5) Name and contact information of the HHA clinical manager (Cornell Law School, 2018).

Need Help with your agency's Condition of participation (CoP) compliance?

For more information about how Select Data can ensure CoP Interpretive Guidelines have been met email info@selectdata.com or call 800-332-0555.

Resources Centers for Medicare & Medicaid Services (2018). Center for Clinical Standards and Quality /Quality, Safety & Oversight Group. Department of Human and Health Services. CMS.gov. Retrieved from: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QSO-18-13-HHA-.pdf Cornell Law School (2018). 42 CFR 484.60 - Condition of participation: Care planning, coordination of services, and quality of care. Legal Information Institute. Retrieved from: https://www.law.cornell.edu/cfr/text/42/484.60
Check out our FREE 30-minute webinar for OASIS-C2 corrections and more. Select Connects with Clinicians Click here to read more.
Select Data is committed to a strong compliance program that includes educating all personnel on mitigating HIPAA breaches. For more information about Select Data and their commitment to quality in Home Health and Hospice, call 1.800. 332.0555.

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New ICD-10 Code Updates: Ask the Right Questions to Get the Right Code

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Clinical Documentation Improvement, Clinical Practices, Coding, Healthcare, ICD-10 CM, OASIS-C2, Uncategorized

New ICD-10 Code Updates: Ask the Right Questions to Get the Right Code

CMS releases updates to the ICD-10-CM coding manual

 
Every October, the CDC and CMS release updates to the ICD-10-CM coding manual. These updates include both codes in the tabular and alphabetical indexes as well as official guideline changes. The following is a summary of some of those changes that Home Health Agencies need to know about.
  • Non-pressure ulcers now have 3 new code subcategories to include those ulcers that are down to the muscle or bone but do not have necrosis and for those ulcers that have tendon/ligaments showing. The clinician should always document the severity of the non-pressure ulcer in terms of skin breakdown, fatty layer, muscle exposed, muscle exposed with necrosis, bone exposed, bone exposed with necrosis, or other appropriate descriptive terms (tendon/ligament, hard eschar, slough obscuring wound bed, etc.).
  • C Diff is now being captured as being recurrent or not stated as being recurrent. Recurrence is defined by complete resolution of C diff symptoms while on appropriate therapy, followed by subsequent return of diarrhea and other symptoms after treatment has been stopped. Recurrence usually occurs within one week after treatment stops but may happen up to 8 weeks later. The physician would need to confirm whether C diff is recurrent or not.
  • Types of myocardial infarctions now play a role in determining the appropriate ICD-10 code. Type 1 is the most common MI which is associated with ischemia and due to primary coronary even. Type 2 MI is due to imbalance in supply and demand of oxygen. Type 3, (which we wouldn’t see in home health), is sudden cardiac death, including cardiac arrest. Type 4 MIs are associated with percutaneous coronary intervention while type 5 MIs are associated with a CABG procedure.
  • Secondary pulmonary hypertension diagnosis code has been further detailed to describe what the condition is that is causing the secondary pulmonary hypertension, including left heart disease, lung disease, etc.
  • Lumbar stenosis should be classified with or without neurogenic claudication. Neurogenic claudication is leg pain with walking. The physician must confirm neurogenic claudication for it to be coded.
  • Bowel obstructions can now be captured as complete or incomplete/partial. Complete bowel obstructions would need surgery to correct while incomplete/partial bowel obstructions can be sent home for it to resolve. The coding specialists need to know whether a bowel obstruction is resolved upon discharge from the hospital. Resolved conditions cannot be coded in home health except for in OASIS items M1011 and M1017 when they reflect the patient’s recent history.
  • New coding guidelines state that if a patient’s visual category is not documented then coding specialists can only code unqualified visual loss. It would be beneficial to query the physician to determine patient’s visual category to be more specific with coding of low vision and blindness. Also, the laterality of the low vision and blindness is necessary in retrieving the most specific code.
Along with these changes come the need for increased specificity for diagnoses. To assign specified codes, coding specialists rely on clinicians and physicians to provide adequate detailed information about each diagnosis being listed on the plan of care. Without this important step, coding specialists are left to code only unspecified diagnoses, which could impact reimbursement, or cause a delay in coding as a query may be necessary. To reduce queries to your clinical leadership and clinicians, here are some tips on being proactive with detailed information:
  • Query the provider for specifics that are not included in the physician documentation prior to completing assessment.
  • Specify sites and laterality of wounds
  • Specify etiology of wounds (surgical, traumatic, diabetic, arterial, venous, etc)
  • Query the provider for late effects of CVA if there are none documented in clinical paperwork
  • List the type of MI the patient experienced
  • Always document patient’s smoking/tobacco use status (current or history of, and what product)
  • Don’t list diagnoses on the plan of care that are not actively being addressed or impacting the plan of care
  • If there are diagnoses listed on the plan of care that will likely impact it, but no direct interventions regarding those conditions are present, document how they will impact the POC
  • Document if patient’s substance disorders are in remission per physician documentation or query to determine this.
  • Document the specific type of heart failure a patient has been diagnosed with
  • Specify which type of diabetes a patient has been diagnosed with, and what, if any, manifestations are present.
For the coding specialists to capture more specific diagnoses based on the clinician’s documentation, clinicians should document in the clinical note that this specific information was provided by the physician. Clinicians can document specificity but unless there is verbiage stating that the condition is physician confirmed, the coding specialists cannot code that specific condition. Select Data enjoys working closely with clinicians to provide the codes being captured in the plan of care. It is truly a team- work experience. If you have any OASIS review or Coding questions please call Select Data at 1.800.332.0555.
Check out our FREE 30-minute webinar for OASIS-C2 corrections and more. Select Connects with Clinicians Click here to read more.

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Coding Is A Fixed Cost-Make It A Return On Investment

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Clinical Documentation Improvement, Healthcare, Value-Based Purchasing

Coding Is A Fixed Cost-Make It A Return On Investment

Leading the way by preparing Home Health Agencies for Value-Based Purchasing

 

We help you focus on patient outcomes

Coding should provide an accurate picture of the patient's clinical condition and help drive the focus of care. Coding to the highest level of specificity is a necessary part of providing quality care. It is not enough to review the entire integrated OASIS assessment for completeness and congruency. We query the agency clinician on incongruencies between the physician orders, clinical record and patient's condition. Our process changes behavior because we engage the clinician when suggesting changes. Have you outsourced coding? Are you happy with it? Select Data provides professional coding services to Home Health and Hospice agencies and are industry experts in the language of CMS. Select Data helps reduce reportable hospital readmissions up to 40%. We assist agencies with the accurate representation of their patient. To find out how Select Data can help you improve coding accuracy check out our OASIS review and coding services. To download the more information on how Select Data reduces reportable hospital readmissions fill out the information below

   
Check out our FREE 30-minute webinar for OASIS-C2 corrections and more. Select Connects with Clinicians click here to read more.
Select Data is committed to a strong compliance program that includes educating all personnel on mitigating HIPAA breaches. For more information about Select Data and their commitment to quality in Home Health and Hospice, call 1.800. 332.0555.

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Wounds and OASIS Documentation

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Clinical Documentation Improvement, Educational Videos, OASIS, OASIS-C2, Wound Care

Wounds and OASIS Documentation Presentation

Wounds and OASIS Documentation Key Facts

 

Upon completion of this session, attendees will be able to:

  • Documenting surgical wounds
  • Identifying and documneting skin ulcers
  • Documenting other skin lesions and skin alteration
To watch the Wounds and OASIS Documentation live presentation fill out your name and email address

Select Data is committed to a strong compliance program that includes educating all personnel on mitigating HIPAA breaches. For more information about Select Data and their commitment to quality in Home Health and Hospice, call 1.800. 332.0555.

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CoPs: Patient Engagement- Start Preparing Now!

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Accountable Care Organizations, Clinical Documentation Improvement, Clinical Practices

Conditions of Participation (CoPs): Patient Engagement - Start Preparing Now!

The majority of newly revised CoP standards become effective in less than four months, July 13, 2017. Have you conducted your gap analysis yet?

 
The new CoPs signal a shift from problem-focused care that CMS acknowledges has had “inherent limits” to quality focused individualized care. CMS wants to “transform” care delivery. The new CoPs (See Select Data ezine February, 2017) promote actively involving the patient in their care. CMS stresses focusing on patient strengths as well as their specific outcome goals. The CoPs also stress using individualized communication methods with patients such as schedules, handwritten notes and charts, etc. How will your agency consistently involve patients, build on their strengths, and work toward mutual outcomes? Some Home Health agencies, in seeking to reduce care fragmentation and improving continuity of care are turning toward integrative models of care. Patient care has changed with greater demands for multi professional teamwork to offering patients collaboration and coordination. More traditional models tend to focus on isolated interventions rather than the total care needs of the patient. Traditional models frequently offer only partial solutions for improving outcomes and coordination of the care process. Integrated Care Models can be central to the patient-centered organizational design and performance. Without integration, health care performance can suffer. This “bottom up” approach to care views patient characteristics and strengths as essential for care plan development. This partnering with patients, families, caregivers, and professional members of the team promotes health literacy and ongoing engaged patient self-management. The cornerstone to integrated care depends on Motivational Interviewing (MI). Motivational Interviewing is a “method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior” (Miller and Rollnick, 2002). MI is goal oriented and patient centered and it is non- confrontational. MI involves developing the ability to ask open-ended questions, to provide affirmations, increase use of reflective listening, and to provide summaries of care provided as well as progress toward goals. Those skills are used strategically reflecting on a typical day and desired change importance. MI is non- argumentative, understanding that knowledge alone disseminated to patients usually will not change behavior. MI requires working with patients to assess their motivators to change behavior which may not be consistent with their personal goals. Motivational Interviewing uses four general processes: Engaging- This means actively involving the patient in talking about their concerns. Engaging requires the clinician to visit with patients and seek their perspective on their health, solicit their interests, and ask about the patient’s desired goals. This is very different than going into the home to “assess” the patient and tell them the plan or to merely “educate” them regarding their disease and its process. Focusing- This process involves narrowing conversation to patterns the patient wants to change. This is a skill that requires practice by the clinician but is highly effective in helping the patient, in a positive manner, to view expressed desired goals and congruence or incongruence with action toward the goals. Evoking- This is a learned technique used to determine the patient’s sense of change readiness. Planning- This process assists in the development of truly collaborative steps to attain goals. One of the key factors learned in using MI in the home health visit process is that structure is essential for visits. Each visit should begin by 1. listening to the patient/caregiver discuss progress or issues encountered since the last visit. Discussion should discuss prior visit assignments; i.e. increasing ambulation steps by 20 each day. 2. Discussing today’s visit activities and goals so they are clear and any questions or comments can be shared. 3. At the conclusion of the visit, the clinician should review what was accomplished during that visit, review any assignments for either the patient or clinician, seek any comments, and discuss the next visit date and time. MI broadens patient/caregiver and clinician perspectives and builds on the momentum for behavior change which can ultimately mean improved outcomes. To learn more about Integrated Care Management consider training and certification at Sutter Center for Integrated Care. Here is a link for more information: http://www.suttercenterforintegratedcare.org/services/Training-Certification.html There are training programs at numerous hospitals including Mass General. For further information contact them at: http://www.umassmed.edu/cipc/icm/overview/ There are numerous books regarding Integrated Care and/or Motivational Interviewing including: Motivational Interviewing by William Miller and Stephen Rollnick.
For more information regarding CoPs or assistance in document review, clinical/coding audits, and Revenue Cycle Management, contact Select Data at 1.800.332.0555.

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Top 5 Challenges Facing Home Health Care Agencies

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Accountable Care Organizations, Clinical Documentation Improvement, Healthcare, The Affordable Care Act (ACO), Value-Based Purchasing

Top 5 Challenges Facing Home Health Care Agencies

Guiding The Home Healthcare Industry to Value-Based Purchasing Thru Clinical Documentation Improvement (CDI)

 
It’s no secret that growth in the home care industry is on the rise. More new agencies emerge on the scene every day. In fact, it’s one of the largest growing trades nationwide, with individual and franchise businesses popping up from coast to coast.  But, it’s also one for the most difficult business opportunities to get a handle on.  Partly because of the tremendous growth and partly because of the numerous fundamental changes occurring simultaneously, the home healthcare industry could be classified as particularly volatile (Kenyon Homecare Consulting, 2014). But despite the challenging nature of the industry, there are some bright spots on the horizon. Most of you agree, for example, that the movement to value, the rise of consumerism, and the use of new technologies could transform the industry for the better—it's just a matter of turning that potential into reality (Brown, 2014). Here are five of the heaviest hitters: Increasing Demand America is home to an aging population. By 2020, an estimated 17% of the entire population will be 65 or older. That’s 50 million men and women who will be increasing their reliance on the healthcare industry as a whole (Halvorson, 2013). With more aging individuals preferring to receive care in the comfort of home, many home care agencies will struggle to meet the growing demand with qualified staff and capable caregivers (Kenyon Homecare Consulting, 2014). Advances in Technology The home health care industry is in the middle of a tremendous technological revolution. In fact, figures released by Lucintel predict over $29 billion in growth by 2017. Older, outdated systems are being replaced with faster, less-intrusive and more powerful equipment. And the home health care industry is struggling to keep up.  Learning how to correctly and effectively use these new gadgets takes a considerable investment of time and effort.  While some agencies are leading the pack, others are lagging behind – put off by either the added cost of the added hassle (Halvorson, 2013). Political Pressure With the ongoing debate about who is right and who is wrong in Washington raging, healthcare is a big fat target for political movers and shakers (Halvorson, 2013). With a Trump Presidency political pressure is at an all-time high. President Trump has promised a repeal of the Affordable Care Act (Obamacare) but, has not outlined how or when. In a debate Tuesday night, Senator Ted Cruz made it clear that nothing is happening yet (Newkirk, 2014). Accountable Care Organization (ACO) Establishing an accountable care arrangement with a payer means entering into a total-cost-of-care system that rewards or penalizes based on the total cost of a patient population. These complex arrangements are growing even faster than bundled payments. There were approximately 500 ACOs as of year-end 2013. CMS announced 123 new ACOs that would start in January 2014. According to a Premier survey, ACO participation has almost quadrupled since spring 2012, and should continue to grow with participation projected to double by the end of 2014 to 50 percent of all hospitals participating (Brown, 2014). Home health agencies should be encouraging discussions among provider leaders of all levels of the care continuum. Patient ultimate outcomes should be shared by all providers. Establishing those mutual patient outcomes is a primary step in a strategic alliance between ACOs and PCMHs. It may be wise for some organizations to ease into the ACO world incrementally by starting with P4P and bundled payments. Entering into shared savings agreements is one of the main strategies hospitals must pursue to survive in this environment. Value-Based Purchasing However, the number one most challenging factor impacting Home Health Care agencies is the transition to value-based purchasing. Moving to value-based reimbursement continues to be a top challenge, according to our survey. While most respondents said their organization has at least started shifting its operations toward value, nearly one out of every five said they have not yet started transitioning and are "waiting to see what works for other organizations." How does Select Data improve your Agency's quality? Select Data improves your Agency's quality through our Clinical Documentation Improvement (CDI) system. Clinical documentation is at the core of every patient encounter (Ahima, 2017). Consider Select Data as a partner in achieving the best patient plan of care for the diagnoses to be coded and the goals needed to achieve those high quality goals and succeed with the CMS quality measures. Select Data improves your clinical documentation and provides a clear picture of your patient's health. Don’t wait, if you are an agency in one of the 41 states not yet officially affected. VBP is here to stay. Payors other than CMS are also looking at patient outcomes by diagnoses and using that factor as a guide as to whether or not they wish to contract with a provider. For a small Medicare certified agency, a 3% reduction in payment will be painful and a 5% reduction could be unsustainable. You need to be active in VBP education NOW! You may need to designate a position only for data analytics. You need to have strong partners whether in your EMR, your coding and document review, or in analyzing and providing the best plan of care for the patient in order to meet the VBP outcome level goals. Call Select Data at 1.800.332.0555 for more information. References Ahima (2017). Clinical Documentation Improvement: Overview. Retrieved from: http://www.ahima.org/topics/cdi Brown, Bobbi (2014) Healthcare Payers and Providers: The Best System for Process Improvement. Retrieved from: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/top-5-industry-challenges-2016 Top 5 industry challenges of 2016 Halvorson, Chad (2013). Top 7 Challenges Facing Home Health Care Agencies in 2013. Retrieved from: https://wheniwork.com/blog/top-7-challenges-facing-home-health-care-agencies-in-2013/ Kenyon Homecare Consulting (2014). Top 5 Challenges Facing Home Care Agencies in 2014. Retrieved from: http://www.kenyonhcc.com/top-5-challenges-facing-home-care-agencies-2014/ Newkirk, Vann (2017). Republicans Don't Know How or When to Repeal Obamacare. Retrieved from: https://www.theatlantic.com/politics/archive/2017/02/nobody-knows-when-obamacare-repeal-is-happening/515955/
Related articles https://www.selectdata.com/value-based-purchasing-glance/ https://www.selectdata.com/home-health-value-based-purchasing-model-one-year-old-growing/

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Value-Based Purchasing At A Glance

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Accountable Care Organizations, Clinical Documentation Improvement, The Affordable Care Act (ACO), Value-Based Purchasing

Value-Based Purchasing At A Glance

Successfully Navigating the Home Healthcare Industry to Value-Based Purchasing Through Clinical Documentation Improvement (CDI)

 
On April 29, 2011, the healthcare industry changed forever. It’s on that date that the Centers for Medicare and Medicaid Services (CMS) released its Hospital Value-Based Purchasing (VBP) Final Rule, required under the Patient Protection and Affordable Care Act (StuderGroup, 2016). What is Value-Based Purchasing? The Hospital Value-Based Purchasing (VBP) Program is a Centers for Medicare & Medicaid Services (CMS) initiative that rewards acute-care hospitals with incentive payments for the quality of care they provide to Medicare beneficiaries. How does Hospital VBP Work? CMS rewards hospitals based on:
  • The quality of care provided to Medicare patients;
  • How closely best clinical practices are followed; and
  • How well hospitals enhance patients’ experiences of care during hospital stays.
Hospitals are no longer paid solely on the quantity of services they provide. The Affordable Care Act of 2010 established the Hospital VBP Program, which applies to payments beginning in Fiscal Year (FY) 2013 and affects payment for inpatient stays in more than 3,000 hospitals across the country (cms.gov, 2016). How to improve your Agencies quality?
  • You must build a solid foundation...
  • Great field clinicians are not necessity
How does Select Data improve your Agencies quality? Through Clinical Documentation Improvement (CDI). Clinical documentation is at the core of every patient encounter (Ahima, 2017). Consider Select Data as a partner in achieving the best patient plan of care for the diagnoses to be coded and the goals needed to achieve those high quality goals and succeed with the CMS quality measures. Select Data improves your clinical documentation and provides a clear picture of your patients health. Don’t wait, if you are an agency in one of the 41 states not yet officially affected. VBP is here to stay. Payors other than CMS are also looking at patient outcomes by diagnoses and using that factor as a guide as to whether or not they wish to contract with a provider. For a small Medicare certified agency, a 3% reduction in payment will be painful and a 5% reduction could be unsustainable. You need to be active in VBP education NOW! You may need to designate a position only for data analytics. You need to have strong partners whether in your EMR, your coding and document review, or in analyzing and providing the best plan of care for the patient in order to meet the VBP outcome level goals. Call Select Data at 1.800.332.0555 for more information. References Ahima (2017). Clinical Documentation Improvement: Overview. Retrieved from: http://www.ahima.org/topics/cdi CMS.gov (2016). Hospital Value-Based Purchasing. Department of Health and Humans Services: Centers for Medicare & Medicaid Services. Retrieved from: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Hospital_VBPurchasing_Fact_Sheet_ICN907664.pdf Studer Group (2016). VALUE-BASED PURCHASING AT A GLANCE:Fiscal Year 2016 and Your Organization. Studergroup.com. Retrieved from: https://www.studergroup.com/industry-impact/value-based-purchasing
Select Data is committed to a strong compliance program that includes educating all personnel on mitigating HIPAA breaches. For more information about Select Data and their commitment to quality in Home Health and Hospice, call 1.800. 332.0555. Click here to contact us.

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