PDGM Turns Two

January 11, 2022 Home Health
The Medicare PDGM Prospective Payment System for Home Health recognized its second birthday on January 1st of this year. With two years of real-time data, I was interested in comparing the PDGM components and other key indicators to see how the second year compared to the first using the SHP National Database and the CMS CY 2022 Final Rule datasets. CMS also updated the Case-Mix Weights (CMWs) for each of the 432 Home Health Resource Groups (HHRGs) based on their analysis of CY 2020 claims (run as of July 12th, 2021). They used a four-step regression model that applied CY 2019 costs per visit (minutes) and non-routine supplies from claims to determine average resource use and the corresponding CMWs.

SHP releases OASIS-D1 to OASIS-E Crosswalk Guide

December 14, 2021 Home Health
With the OASIS-E assessment form going into effect on January 1st, 2023, SHP is pleased to provide home health agencies with a complete side-by-side comparison of the OASIS-D1 and expected OASIS-E assessment forms. Items that have been added or removed between the two OASIS versions are indicated with color coding.

CMS Home Health Final Rule delays HHVBP National Expansion

November 18, 2021 Home Health
In the Medicare and Medicaid CY 2022 Home Health Prospective Payment System Rate Final Rule, CMS finalized the Home Health Value-Based Program (HHVBP) national expansion based on their original proposal. However, there is one exception - a one year delay in implementing the program. This is good news for providers in the 41 states which are currently not part of the CMMI HHVBP demonstration, but agencies are still expected to use this time to prepare.

CMS Seeks to Expand HHVBP Nationally

August 31, 2021 Home Health
In the CY 2022 HH Proposed Rule, CMS is expanding the Home Health Value-Based Purchasing Program (HHVBP) to all 50 states effective January 1, 2022. HHVBP has been one of the few demonstration projects of the Center for Medicare and Medicaid Innovations (CMMI) that actually saved money. With the expected implementation soon approaching, home health agencies (HHAs) should take the time today to understand the HHVBP model design, the proposed CY 2022 performance year outcome measures, and the calculations that CMS will be using to determine whether your agency will be eligible for a bonus or penalty up to 5 percent of your agency’s Medicare FFS revenue.

CMS HH Proposed Rule Punts PDGM Behavioral Change Adjustments Again

August 11, 2021 Home Health
The Center for Medicare and Medicaid Services (CMS) issued the CY 2022 Home Health (HH) Prospective Payment Rate proposed rule in the Federal Register last month and all eyes were focused on whether they would propose any rate adjustments based on changes in coding or other behaviors due to the implementation of the Patient-Driven Groupings Model (PDGM). Although CMS suggests that they have overpaid HH up to 6% compared to the prior PPS model, CMS kicked the can ahead again in the 2022 proposed rule.

CareStat 2.0 released to help hospitals and ACOs build strong relationships with post-acute providers

SHP is excited to announce the launch of the next version of our CareStat® solution. CareStat by SHP connects hospitals/ACOs with home health agencies (and soon SNFs) to provide insights into your patients’ outcomes across the care continuum. With CareStat’s new and improved suite of reports and its real-time relevant data, hospitals can impact readmissions, length-of-stay, clinical outcomes, and patient satisfaction.

New Unplanned Rehospitalization Report Released

SHP is excited to announce a valuable new report available in our IntelliLogix solution for skilled nursing facilities. The Unplanned Re-hospitalization Trend Report is a tool designed to help organizations monitor their unplanned re-hospitalization rates by category and over time. We hope these insightful analytics will help facilities to pin-point risk factors and identify the best course of action for improvement.

The Hospice Quality Reporting Program (HQRP) Star Ratings are Coming!

April 20, 2021 Hospice
The Centers for Medicare and Medicaid Services (CMS) released their annual Hospice Wage and Payment Rate proposed rule for FY 2022 in the Federal Register on April 14 and there was plenty of updates regarding the HQRP. Many were expected but the one I found noteworthy is the addition of public reporting for a new CAHPS Hospice Survey Star Rating.