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| THE PATHFINDER NEWSLETTER |
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Hello!
Welcome to the July 2011 issue of THE PATHFINDER.
I've been trying to find a quiet moment for the last week or so to organize this month’s newsletter. I wish I could tell you that the reason I have been distracted is because I've been reading a “beach book”, feeling the sand between my toes and listening to the sound of crashing waves on the shore. It is summer after all. However, that has not been the case!
Instead the phone has been ringing with clients who are worried, feeling anxious about the future, caught up with operational and clinical issues.
There are a lot of challenges facing the home health industry and the nation as a whole. With even more funding cutbacks ahead and the need to improve outcomes with fewer resources, we have to look at how we deliver our services, who delivers the care, how we measure our results. Technology is more than laptops today. Telehealth is not just for home care, but hospice as well.
We all get caught up in the day-to-day efforts to provide appropriate care, our billing issues, compliance concerns and financial outlooks. I want to encourage you to set a time - actually schedule time - to think about where you want to be in two years, five years. (And my advice...do your thinking over a second cup of coffee at your kitchen table BEFORE you get into the office and the demands on your time begin.) Without creating your vision of success, you will never be able to create the roadmap to achieve your vision.
In this month’s newsletter I have included two articles from Elizabeth Hogue on ACOs. Not only do the articles give good information on ACOs, but they also help agencies plan for the world with these organizations.
The second article is by Reginald Hislop on the OIG’s recommendations to revamp payment to hospices serving patients in SNFs. As always he presents his position clearly and strongly. I cannot argue with Reg's statement of the statistics. He and I could discuss the use of diagnoses such as debility non-specified, and adult failure to thrive in the SNF setting. What makes me uncomfortable is the reset of the for-profit versus not-for-profit issue. It is not just for-profits who have discovered how to maximize reimbursement of hospice patients. And when all is said and done, I don’t want any of us to lose sight of the fact that there are SNF residents who need and can - appropriately, legitimately - benefit hospice services.
Take some time to enjoy this season. I hope each and every one of you have the opportunity to enjoy a quiet summer evening watching a sunset, the opportunity to hear the laughter of children splashing in a pool and take a ride in a convertible with the Beach Boys turned up loud!
If we can provide you with any assistance, please do not hesitate to contact us.
Best wishes, Beth Carpenter
“Let us realize that the privilege to work is a gift, that the power to work is a blessing, that the love of work is success.” David O. McKay |
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Part 1: Accountable Care Organizations (ACO’s) Proposed Regulations
By Elizabeth Hogue, Esq
Section 302 of the Affordable Care Act (ACA) includes provisions related to Medicare payments to providers of services and suppliers that participate in Accountable Care Organizations (ACO’s). Providers of services and suppliers who participate in ACO’s will continue to receive payments under Parts A and B of the Medicare Program, but will also be eligible for additional payments if they meet certain requirements related to quality of care and cost savings.
To read further, please click here
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Part 2: Accountable Care Organizations (ACO’s) What Post-Acute Providers Should Do Now
By Elizabeth Hogue, Esq
This is the second in a series of articles about ACO’s. The purpose of this article is to help post-acute providers understand what they need to do now with regard to ACO’s.
As indicated above, ACO’s will share in cost savings if they meet performance standards for both quality of care and cost savings. Post-acute providers may assist ACO’s to meet standards related to quality of care.
To continue, please click here |
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OIG on Hospice: Restructure Hospice Payments for SNF Residents
By Reginald M. Hislop, III
This past week, the OIG released a report that represents a more definitive study of hospice payments and utilization trends under Medicare. The
report is effectively a follow-up to recommendations made in MedPac's annual report(s) to Congress. The report provides a review of OIG’s analysis of the growth of Medicare covered hospice patients over the period 2005 - 2009, specifically as such growth
relates to the provision of Hospice services within SNFs. For the last three to four years, MedPac and to a lesser extent OIG, have commented about the rapid growth of hospice utilization under the Medicare benefit and the corollary relationship between this growth and SNFs, particularly as the same relates to for-profit hospice organizations.
Per OIG, Medicare spending for hospice services provided to SNF residents increased 69% between 2005 and 2009. In total dollars, the amount grew from $2.55 billion to $4.31 billion. During this period, the number of hospice beneficiaries residing
in SNFs grew by 40%. Not surprising, during this same period the total number of hospices participating in Medicare also grew; the growth dominated by for-profit organizations. According to the OIG, hospices organized for-profit received higher levels of reimbursement on average (29%) compared to non-profit and governmental operated hospices.
To read further, please click here. |
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WE ARE PLEASED TO ANNOUNCE A NEW SERVICE
Accreditation Commission for Health Care
Beth Carpenter and Associates is proud to announce the addition of a new service for its clients! We are now able to support your efforts to achieve accreditation through Accreditation Commission for Health Care (ACHC) whether you are a new or existing agency - home health, hospice or private duty.
To assist you in your efforts to reach and maintain deemed status for Home Health and Hospice agencies as well as accreditation as a Private Duty Nursing and/or Private Duty Aide organization, the following are a sample of potential services currently available through Beth Carpenter and Associates:
• Assistance in preparation of the ACHC Application and the Preliminary Evidence Report (PER).
• Review of your Application and PER prior to submission to ACHC.
• Assistance with any revisions to the PER requested by ACHC following initial submission.
• Training and instruction to administration and staff to prepare for an on-site ACHC survey.
• Assistance in creating a Plan of Correction, if necessary, following an on-site ACHC survey.
Subsequent to successful accreditation, we are available to work with your agency to continue compliance with the ACHC standards.
For further information, call 847-382-1035 or e-mail bcarpenter@bethcarpenterandassociates.com. |
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Beth Carpenter
Beth Carpenter and Associates 847-382-1035
bcarpenter@bethcarpenterandassociates.com
Beth Carpenter and Associates has earned a reputation as a company with deep industry experience and one that works closely with its clients to identify solutions that meet their business goals and strategic objectives. We do not simply advise. We partner with our customers to implement the solution and ensure its success.
Sincerely, Beth Carpenter |
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ARE YOU ON THE RIGHT PATH?
Since 1995 Beth Carpenter and Associates has provided its real-world experience to the management of healthcare companies, especially those organizations with a focus on home health, hospice and private duty, in the areas of operations, clinical services, sales and marketing. We work with management to identify the strategic direction of the organization and implement the necessary changes that allow health care providers to move forward in today's environment.
We help you choose the right path to success and then we walk it with you. |
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