Showing posts tagged with: Healthcare

American Heart Month

Admin
0 comments
Healthcare

American Heart Month

February is American Heart Month

 
Beginnings On December 30, 1963, President Lyndon B Johnson declared by order of proclamation that February would be American Heart Month. The first American Heart Month took place in February 1964. At that time more than half the deaths in the United States were caused by cardiovascular disease. Of the 10 million Americans afflicted, half were afflicted during their most productive years which resulted in a staggering physical and economic loss to the nation. Current State of Heart Disease At 17.3 million deaths, annually, heart disease and stroke remain the leading global cause of death. This number is expected to rise to more than 23.6 million by 2030. The educational efforts, that began 53 years ago, have made a difference. Currently, 27.6 million adults are diagnosed with heart disease which represents 11.5% of the population. Despite the improvements, our work in this industry is not done. Since 2014, Heart Disease remains the leading cause of death in the United States (US). With over 3.7 million patients hospitalized in 2010, Heart Disease remains the 2nd leading cause of hospitalization in the US behind childbirth with 3.9 million deaths. The most expensive procedures performed in 2015, across all ages, were heart related with heart valve procedures representing the highest cost at $51,425 per procedure. What can you do? The first thing to do is become informed. The next step is to take your knowledge and take charge of your health. You are your own best advocate. According to the American Heart Association knowing your cholesterol is vitally important, as too much cholesterol and fats can build up causing the arteries to narrow and diminishing the blood flow. This causes the heart, brain and other organs to lose its blood supply and with it oxygen and cause a heart attack or stroke. Know your numbers:
  • Cholesterol-Talk to your doctor about your numbers and how they impact you.
  • Body Mass Index (BMI) should be less than or equal to 25kg/m2
  • Blood Pressure of less than 120/80 mm/Hg
  • Fasting blood sugar of less than or equal to 100mg/dl
  • Exercise at least 150 minutes a week of moderate intensity exercise, such as brisk walking. 30 minutes a day, 5 days a week are easier numbers to remember.
The importance of Diabetes prevention and management cannot be over stressed. Diabetes is a major risk factor for stroke and heart disease. Uncontrolled Diabetes causes damage to your body’s blood vessels making them more prone to damage from high blood pressure and high cholesterol. What do we do? Select Data will continue to do what we do best and that is to ensure that the most accurate story of the patient is told in the way our researchers, government, and payers understand, through your patients’ codes. Accurate diagnosis coding provides scientists, clinical leaders, thought leaders and yes, the finance leaders with information about our population. It’s through this information they know about the population you serve, how sick your patients are, and what their true needs are. Without accurate data, diagnosis codes, smart decisions can’t be made. These diagnoses along with the data collected via the OASIS and other data collection instruments provide decision makers with valuable information on how to distribute funds, what regulations to change, where to focus research and ultimately the best setting for patient care. Each document reviewed, every code assigned paints a picture of your patient, your agency and your care. Select Data will continue to ensure that it’s correct. It’s what we do. Resources http://www.world-heart-federation.org/cardiovascular-health/cardiovascular-disease-risk-factors/diabetes/ https://www.cdc.gov/nchs/fastats/heart-disease.htm https://c2c476bb6ef038abb8b6-ab5c6310bff1587205981e56ac38a65f.ssl.cf1.rackcdn.com/wp-content/uploads/2016/05/GRFW_Get-Your-Numbers-Cardio-Health-Guide.pdf
Check out our FREE 30-minute webinar for OASIS-C2 corrections and more. Select Connects with Clinicians webinar on December 14, 2016. 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.

Read more

CoPs Delayed a Proposed 6 Months. Breathe a Sigh of Relief, but Don’t Relax as You Have Much Work to do.

Admin
0 comments
Clinical Practices, Conditions of Participation (CoPs), Healthcare, HIPPA, Legislation, Uncategorized

CoPs Delayed a Proposed 6 Months!!!

Breathe a Sigh of Relief, but Don’t Relax as You Have Much Work to do.

 
CMS has proposed delaying the new Conditions of Participation (CoPs) for six months, until January 13, 2018.  QAPI  implementation would be required in July, 2018. Though a 60 day comment period is required, it is unlikely that home health agencies will complain and demand to implement the new CoPs sooner, so industry experts are saying we can presume the delay will occur. Agencies have expressed relief as the CoP changes were significant and many HHA expressed concern that there was inadequate time to prepare.  But don’t sit back with this postponement. You have much work to do. The Changes in General The organizational structure of the regulations was changed dividing the general provisions into three subparts: general provisions, patient care, and organizational environment. Certain CoPs were consolidated; i.e. Skilled Nursing, Therapy Services, and Medical Social Services were consolidated into Professional Services. Two CoPs were added; Quality Assessment and PI (QAPI) and Infection prevention and control. Many of the remaining standards were revised significantly: Patient Rights, Comprehensive Assessment, Care Planning/Care Coordination, Home Health Aide, Organization and Administration, Clinical Records, and Personnel Qualifications. The CMS Focus The focus is one of integrated care processes including:
  1. A patient-centered assessment with measureable outcomes.
  2. Patient-specific care planning and service delivery
  3. Agency-specific processes for Quality Assessment and Performance with active Governing Body involvement
  Transforming the CoPs CMS has found that directing a QA approach toward identifying providers that furnish poor quality or failed to meet minimum Federal standards does not always  work. CMS stated, “We have found that this problem-focused approach has inherent limits.” CMS wants to stimulate broad-based improvements in the quality of care delivered to all patients.  They want “Patient-centered, data-driven, outcome-oriented processes promoting high quality care for all patients at all times.” Surveyors are undergoing intensive new training. Some of the Action Items that an Agency May Need to Complete Intensive education for all personnel especially in the areas of patient rights, comprehensive assessment with ongoing POC updates, and patient engagement. Active patient involvement in their POC. New updated Patient Rights Forms with names and addresses and phone numbers of care givers.  Have space on the form for the Patient/Legal Representative to sign. Make certain the new CoP language is included in the Patient Rights form. Have copies of policies regarding admission, transfer, and discharge available for patients that reflect the new standards. Be certain the patient knows the Clinical Manager’s name and number to call with any clinical questions. It is now required under the CoPs to provide the Administrator’s name and number to call with any complaints. CMS is seeking a more “holistic patient assessment.” This means they expect the agency to develop a better understanding of the patient; knowing their strengths and abilities for active involvement in their own care plan and ultimate outcomes. How will your agency ensure this process?  Will it be Integrative Care Management?  Is education and training needed? Educate personnel to identify signs and symptoms of stress in the caregiver as well as how to speak with the caregiver re strain and burdens of care. Will you use a screening tool? Identify where you will note the education and training for patients and their specific needs. A one- size fits all care plan for a specific diagnosis will no longer be sufficient. How will revisions to the care plan be flagged so clinicians know they are working with the most current POC? The POC is to become an “evolving document.” CMS is stressing team care. The new CoPs require agencies to coordinate care delivery. How will your HH interdisciplinary team communicate? “Coordinated care requires communication with integration of orders with all physicians.” A patient hospital risk assessment is required for all HHA admissions.” All patient orders, including verbal orders must be recorded in the POC. They must have not only the date, but the time of the order noted. “The HHA must develop, implement, evaluate, and maintain an effective ongoing, HHA-wide, data-driven program. The HHA governing body must ensure that the program reflects the complexity of its organization and services, involves all HHA services including those services provided under contract or arrangement, focuses on indicators needed to improve outcomes, including hospital admissions and readmissions and takes actions that address the HHA performance across the spectrum of care including the prevention and reduction of medical errors. The HHA must maintain documentary evidence of the QAPI program and be able to demonstrate its operation to CMS.” A plan to educate/ consult with the Governing body re the new CoPs as well as each QAPI project is required. Agency must create new policies and procedures, modify and/or update certain old P&P in keeping with new CoPs and consolidation of certain old standards. Are new job description modifications needed? As to infection control; what new P&P are needed? What surveillance, identification, prevention, control, and investigation program will be put in place to meet the new standard?  Of course this will require further education and training for personnel. As to home health aides: What education and training modifications will be required to meet the new communication requirements? What changes will be needed to the policies, procedures, and job descriptions? What about your agency cybersecurity and Emergency Preparedness Plans? Your system must include a system of medical documentation that preserves patient information, protects confidentiality, and maintains availability of records. So, you may think of the postponement as a reprieve, but it is a short one. As you can see…there is much to do, so get started now. For assistance with your coding, documentation review, and revenue cycle management needs, contact Select Data at 1.800.332.0555. We are  100% USA based, here to assist you.
Related articles New Conditions of Participation (CoPs) and Your Agency Check out our FREE 30-minute webinar for OASIS-C2 corrections and more. Select Connects with Clinicians webinar on December 14, 2016. 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.

Read more

Home Health Value Based Purchasing Model: It’s One Year Old and Growing

Admin
0 comments
Clinical Practices, The Affordable Care Act (ACO), Value-Based Purchasing

Home Health Value Based Purchasing Model: It’s One Year Old and Growing

Successfully Navigating the Home Healthcare Industry to Value Based Purchasing

 
Last January, 2016, the CMS Innovation Center launched the Home Health Value Based Purchasing (HHVBPM) aka VBP Model in the following nine states:
  • Arizona
  • Florida
  • Iowa
  • Maryland
  • Massachusetts
  • Nebraska
  • North Carolina
  • Tennessee
  • Washington
This is part of a larger movement across the healthcare system in the US. CMS, as well as other payors want payment tied more closely to the quality of care delivered.  CMS wants to reward those Medicare certified agencies that perform well on select quality measures. The belief is that those agencies that perform well under VBP will have an increase in revenue and those agencies that cannot perform well with the identified quality measures will be penalized by shrinking margins. The maximum payment adjustments are planned as follows:
  • 3% upward or downward in 2018
  • 5% upward or downward in 2019
  • 6% upward or downward in 2020
  • 7% upward or downward in 2021and
  • 8% upward or downward in 2022
CMS expects to expand the VBP model to other states in the future. There were originally 24 quality measures proposed for review, however in June, 2016, CMS proposed dropping four of those measures.  Using data from OASIS, Medicare claims, HHCAHPS surveys, and other reported data, agencies will be evaluated quarterly receiving reports on their performance compared to their baseline in previous quarters as well as how their performance stands up against other agencies within their state. There are nine quality outcome measures used to determine payment awards:
  • Improvement in Ambulation
  • Improvement in Dyspnea
  • Improvement in Bed Transferring
  • Improvement in Bathing
  • Improvement in pain interfering with activity
  • Improvement in Oral Medication Management
  • Emergency department use without hospitalization
  • Acute Care Hospitalization
  • Discharge to the Community
There are three quality process measures used to determine payment awards:
  • Influenza immunization received
  • Pneumococcal vaccine received
  • Medication education
There are five consumer outcome measures used to determine payment awards
  • Care of patients
  • Specific Care issues
  • Communication between the patient and the care provider
  • Patient willingness to recommend the provider of care
  • Patient’s overall rating
There are three new additional measures used to determine payment awards:
  • Influenza vaccination for provider’s home health personnel
  • Herpes zoster vaccination for provider’s home health personnel
  • Advanced care planning
Using the above measures, agencies will receive an “achievement score” that compares an agency to peer agencies and an “improvement score” that compares the agency with their baseline year. For each process and outcome measure, those two scores will be calculated and the higher of the two scores will count toward the agency’s overall “Total Performance Score (TPS).”  The three new measures count toward 10% of the total score. What can your agency do to positively impact the agency’s score?
  • Your agency must become educated in the HHVBP model and the measures.
  • Industry experts believe CMS will implement this nationwide sooner than anticipated. Look at each item and hone in on 1-2 items at a time. Consider focusing on the process measures, as they are seen to be easier to affect change.
  • If you are a high performing agency, then more opportunity may exist with achievement scores.
  • If your agency has consistently struggled, focus on the improvement scores.
  • Conduct a gap analysis as to clinician understanding of each OASIS and HHCAHP item.
  • Provide OASIS education specifics. Hone in on SOC opportunities for assessment evaluation.
  • Provide clinician education regarding HHCAHPS and the questions that will impact your agency.
  • Be certain your agency’s software has the capability to assist in analysis of clinical documentation analytics and reporting regarding OASIS and Claims data.
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. 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. Call Select Data at 1.800.332.0555 for more information.
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.

Read more

January is National Glaucoma Awareness Month

Admin
0 comments
Healthcare

January is National Glaucoma Awareness Month

An important time to spread the word about this sight-stealing disease.

 
Currently, more than 3 million people in the United States have glaucoma. The National Eye Institute projects this number will reach 4.2 million by 2030, a 58 percent increase. In the United States, approximately 120,000 are blind from glaucoma, accounting for 9% to 12% of all cases of blindness. Here are three ways you can help raise awareness:

Help Raise Awareness

  1. Talk to friends and family about glaucoma. If you have glaucoma, don’t keep it a secret. Let your family members know.
  2. Refer a friend to our web site, www.glaucoma.org.
  3. Request to have a free educational booklet sent to you or a friend.
  4. Get involved in your community through fundraisers, information sessions, group discussions, inviting expert speakers, and more (Glaucoma.org, 2016).
 

What is glaucoma?

Visual loss from glaucoma results from characteristic deterioration of the optic nerve leading to progressive loss of the field of vision. At least 3 million Americans suffer from glaucoma. Glaucoma is one of the leading causes of adult blindness, and it is also the leading cause of preventable blindness. Most people who go blind from glaucoma are blind in at least one eye at the time of original detection, which points to the need for better early diagnosis. Because glaucoma usually does not manifest any symptoms until extensive peripheral visual loss becomes apparent in the final stages of the disease, it is often likened to the “sneak thief of sight.” Unlike most eye diseases, most varieties of glaucoma are chronic, virtually lifelong disorders than can be controlled but not cured. Like diabetes, high blood pressure, asthma, or arthritis, glaucoma requires some modification in lifestyle, such as compliance with medical regimens, regular physician visits, and acknowledgment of the disease to achieve successful treatment (Cioffi & Van Buskirk, 2016). Connect with us on Facebook or follow us on Twitter for regular updates on glaucoma research, treatments, news and information. Share information about glaucoma with your friends and family. For more information visit www.glaucoma.org/news/glaucoma-awareness-month.php

References

Cioffi, G. A., & Van Buskirk, E.M. (2016). Glaucoma Basics & Frequently Asked Questions. American Glaucoma Society (AGS). Retrieved from: http://www.americanglaucomasociety.net/patients/faqs#A1 Glaucoma.org (2016). January is Glaucoma Awareness Month. Retrieved from: http://www.glaucoma.org/news/glaucoma-awareness-month.php
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.

Read more

Learn How

Select Data can improve your agency's productivity while increasing your profitablility...

370x275

WATCH DEMO

Article Categories