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Cathy Sorenson was skeptical but desperate. With an average daily census over 400 but a profit margin at a barely surviving level, the President and CEO of Home Healthcare Hospice and Community Services in Keene, New Hampshire, frankly rated her agency’s overall performance as ‘mediocre’ and was ready to try anything to draw the best […]

Over the length of the PPS era, HHSM has developed and employed S.U.R.C.H., their Utilization Review model for Home Health Providers, to outstanding levels of clinical and financial results. Despite an ever-changing PPS model, S.U.R.C.H. has consistently produced increased outcomes, elevated care value, and improved Case-Mix/HHRG results; all while improving quality Star Ratings. Based on […]

This series of articles from HHSM addresses the latest CMS demonstration projects for Home Health; a fraud-preventing protocol that includes a Medicare Prior Authorization of Home Health Services Demonstration project, as well as a Medicare Probable Fraud Measurement Pilot. In this two-part series, we will examine the proposed pilot programs, Home Health integrity concerns that […]

The Affordable Care Act (ACA), passed in 2010, addresses Care Redesign through the establishment of the Accountable Care Organization (ACO) model which seeks to rewire care in terms of wellness, efficiency, and cost reduction. Since the ACA became law, a steady series of programming changes have been rolled out, and additional elements of the reform […]

As we in Home Health move into the calendar year 2015, we confront what is a rapidly changing care landscape, focused on reform efforts that challenge us from many angles. Though payment cuts represent business as usual in the homecare industry, those rate reductions now materialize in rebasing and Case-Mix scoring changes that result in […]

The Affordable Care Act (ACA) will define the healthcare management, production, and delivery processes of the future by rewiring the philosophies and financial incentives in the current care continuum. Health systems across the country are beginning to internalize and address the challenges they will confront as a result of the ACA care models, and Post-Acute […]

From the 2015 Home Health PPS Proposed Rule to CMS Value-Based Purchasing: A Home Health Roadmap for Tomorrow CMS recently released the 2015 Home Health PPS Proposed Rule to outline Medicare benefit changes that will take effect next year. The Proposed Rule, open for public comment for 90 days, is an annual ritual for Home […]

Revisiting Rebasing Water cooler talk in the homecare industry has recently centered on the payment of 2014 claims, and the real-time effects of this year’s Case-Mix Rebasing on reimbursement levels. Most Home Health Providers crossed their fingers and hoped for the best in light of the 2014 PPS Final Rule Update and the installation of […]

The article below is reprinted from Tim Rowan of Rowan Consulting Associates in the Home Care Technology Report, originally published on April 23, 2014. by Liz Seegert Sometimes reality is not pretty, but it is still reality. “If home care companies do not change their mindset about how they do business in this post-ACA era, […]