As contractual rehab service providers, we were compelled to provide better outcomes in our clinical patient programs to attract more business. When reimbursement concerns led to the era of case management, reviewing our cases with utilization representatives helped us identify efficient clinical pathways while still achieving patient success. The Balanced Budget Act gave us further insight into homecare management when we re-engineered our SNF contracts to address BBA reforms. We quickly noted that the adaptation of techniques required to address PPS changes also applied in the Medicare home health environment.
The resultant programming flexibility was a direct product of our SNF rehab style; achieve functional and safe return to home quickly, then efficiently establish (or provide) homecare services. This assertive, outcome-based model enabled us to provide services up and down the ever-evolving continuum of care. As Medicare established compliance regulations and voiced concerns regarding fraud and abuse, HHSM found their lean but efficient service model could do more than effect a single patient. At HHSM we developed the ability to help associates achieve desirable results with thousands of patients as we introduced our program to multiple agencies.
Eventually, our publishing and seminar ventures allowed us to refine and define our exciting clinical homecare training program. We currently provide a number of progressive home health tools and coaching services. Contact us for your opportunity to hear what we can do for your agency’s patients, staff, fiscal and quality outcomes.
Arnie Cisneros, P.T.
As President of Home Health Strategic Management, Arnie has provided clinical services, program development, and management consultation in the areas of Post – Acute care, sports medicine, and Episodic Programming for more than 30 years.
He is renowned for his adaptation of traditional care philosophies to address current and future healthcare reform initiatives. Having delivered care across an evolving care continuum during the PPS era, he is able to position HHSM as the leading Post – Acute consulting firm in terms of rewiring care for quality clinical outcomes. As a result, HHSM has been selected as Post – Acute consultants for multiple Pioneer ACOs, including the awarding and development of a CMS Innovation Center Bundling Pilot Demonstration Project in conjunction with the Detroit Medical Center. The subsequent Bundling program served as the basis of the first mandatory CMS Alternative Payment Model (APM), Comprehensive Care for Joint Replacements (CJR). HHSM subsequently became Post-Acute clinical consultants for the DMC MI Pioneer ACO, managing all DMC discharges for Sub – Acute and Home Health services.
HHSM is a leader in the establishment of a Utilization Review (UR) Model for Home Health care development and delivery. The HHSM UR Model, SURCH – Service Utilization Review for Care in the Home, was named the 2016 VNAA Innovative Home Health Care Model for its ability to successfully address and program care in terms of the quality requirements. The SURCH model routinely increases Care-Mix and HHRG levels >25%, decreases nursing staffing costs while improving productivity, manages care on an in-episode basis, and delivers 4.5 – 5 Star Ratings; all in an audit – proof manner.
Kimberly McCormick, RN/BSN
A highly accomplished nurse consultant in the Home Health industry, Kim is an Executive Clinical Director for Home Health Strategic Management. 24 years experience in Home Health, 8 as Administrator of a Home Health Agency, has given her the experience and the knowledge to provide unrivaled insight into the home care arena. Kimberly served as an Associate Consultant with Home Health Strategic Management for 2 years, during which she has established herself as an expert in the area of Utilization Management of Home Health services. During her time as Administrator, she achieved deficiency-free surveys by The Joint Commission, deficiency-free Department of Health and CMS surveys, and a 0.42% error rate on an ADR audit. Kimberly authors the HHSM nursing newsletter and is presenting nationally on home care topics and care models proposed by CMS and MedPac for the future of the Home Health industry.