Countdown to 2021

Here are 3 priorities home health agencies need to address before the end of the year

Santa’s not the only one making a list and checking it twice this holiday season. Smart home health agencies have their own to-do lists in place for the final weeks of 2020, as they prepare to usher in the new year. “No one will be sorry to see 2020 go, but we still have a few weeks of it left, and we need to use the remaining time wisely,” said J’non Griffin, President of Home Health Solutions, a Simione Coding Company. "There are more big changes coming next year." Griffin and her peers at Simione Healthcare Consultants have spent much of the past few weeks getting home health agencies ready for those changes. Here's her list of three priorities for agencies this December: 1. Shore up intake processes Beginning Jan. 1, the Centers for Medicare and Medicaid Services (CMS) will require agencies to file a non-paying Request Anticipated Payment (RAP) within five days of the start of care for each 30-day billing period, or pay a penalty for each day the RAP is late. The new 5-day RAP will require major changes in timeliness and oversight at most agencies. Griffin advises agencies to implement process changes this month to identify any glitches before the new year. Griffin's key recommendations for shoring up intake processes include:

· Establish accountability. Set up an oversight process to monitor progress to RAP for each patient and test it this month.

· Implement a 24-hour closeout. The RAP cannot be submitted until the first billable visit has been completed, with all documentation in place. Review new processes with staff this month to make certain they understand the importance of timeliness Do all team members know what to do if there is a problem hindering a 24-hour close-out? Make certain every team member fully understands his or her responsibility and how to handle and report problems.

· Set expectations for contract staff. A 24-hour completion requirement is a good idea for contract staff as well. This is the month to make certain your contract staff understands the changes. Consider imposing financial penalties for late turnaround.

· Plan for holidays, weekends and time off. The five-day timeframe for the RAP includes weekends and holidays, as well as employee vacation or sick days. Develop a plan for handling all time off in 2021. Contact agency contractors to make sure they understand how they are expected to handle holidays, illnesses and vacations as well.

· Don’t rush the OASIS. Everything else may be getting faster, but it’s important to use the full 5-day collaborative period to complete the comprehensive assessment. In 2021, the OASIS will not have to be completed in order to submit the RAP. Take time this month to make sure clinicians understand that a faster RAP shouldn’t interfere with careful assessment and collaboration.

· Keep talking to physicians. Getting complete referrals with necessary information for effective care planning will continue to be the cornerstone for home care in 2021. If your agency is still getting confusing, incomplete or inaccurate referrals, make it a priority to continue to communicate with physicians and other practitioners about these crucial needs, and how they impact patients.

Interested in more information on RAPs? Visit the RAPs Resource Page on the Simione web site for access to a free video and helpful printed materials. 2. Find and follow the right metrics

Are you heading into 2021 with the right strategic plan in place – and is it one which can be adapted and course-corrected as needed?

“If 2020 had any lesson at all for home health, it was to expect the unexpected,” Griffin said. “Successful agencies set their goals based on performance-measuring metrics and develop plans that include provisions for handling the unforeseeable.”

Key performance indicators (KPI) will lead your agency into the new year with a clearer understanding of your agency’s strengths and weaknesses in sales, quality, clinical operations, finance and IT, Griffin said.

Need help in identifying key metrics, or developing and implementing a strategic plan? Recordings from Leadership Summit 2020, Simione’s three-day online consult, offer detailed discussion, examples and even a role-playing session to help. Read more here.

3. Explore the benefits of outsourcing

Financial consultants across the business spectrum generally agree on one maxim for profitability, no matter the type of business: If it isn’t a core function (meaning you’re not charging clients for it), you’ll see greater profitability by outsourcing the function.

This is particularly true for home health, where specialized coding & OASIS functions drive revenue. Under Medicare’s Patient-Driven Groupings Model, three-fifths of home health agency reimbursement is driven by accurate coding and OASIS, Griffin said.

Agencies can’t afford to make the mistake of thinking of coding as a standard accounting or payroll function, according to Griffin.

“It’s a specialized field growing more complex daily, and it has direct impact on a reimbursement model made up of nuanced case mix weights, clinical grouping assignment, functional limitations and the potential for comorbidity interaction,” she said.

Simione’s outsourced services can make a significant difference to your company’s profitability – and we offer cost-saving bundles for billing, coding & OASIS and QAPI solutions.

Reach out to us now to get a quote or ask your questions about the difference outsourced services could make for your agency in 2021.