Articles

HHSM Home Health UR Program Receives VNAA 2016 Innovative Model Award

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 […]

Prior Authorization comes to Home Health? Thoughts on this Latest Game-Changer

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 […]

CCJR Arrives in 2016: A New Era for Home Health Joint Replacement Patients

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 […]

2015: A Time for Change in Home Health

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 […]

Are you ready to go “At Risk” for Readmissions?

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 […]

Home Health Roadmap for Tomorrow

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 […]

Breaking News!! HHSM SURCH Results Under Rebasing are In!!

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 […]

Cisneros Delivers Hard Truths About Home Care’s Future

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, […]