The new proposal set for 2018 into 2019 seeks to put in place cuts of about $480 000 000 which will effectively alter the way businesses operate. The CMS will also have some more than significant alterations to the PPS starting from the beginning of January 2019. This comes on the backbone of the IMPACT act that still penetrates our OASIS and that of the post acute providers To be more specific, the proposal seeks to a new method called the home health groupings model. This methodology is previewed to decrease all payment rates and units to a 30day care interval. Unlike the current rules that use set thresholds to determine payments, the HHGM will depend on clinical profiles and patient data to set payments. The proposal also includes possible changes to the HH Value-Based Purchasing program, one of the major changes will be an increase in the total number of cases required for payment.
The proposed changes for 2018-2019 will see the introduction of 30-day episodes among other changes. These proposals will alter the course of home health, it is important that you develop an understanding of how the future system will work.
The proposed rule for 2018 includes another cut for 2018. There are changes to the case mix variable table, and 30-day episodes are on the way!
J’non Griffin is a 30 year veteran of home care as an RN. She received her Master’s Degree in Health Care Administration in 2005. She has experience as a field nurse, director and executive with home health and hospice agencies, both large and small. She has served as Director of Staff Development and Appeals for home health and hospice agencies. She has taken part in mock surveys for agencies, and prepared agencies for accreditation. She has been directly involved in accreditation surveys, acquisitions and many regulatory crises with state survey agencies and the intermediary. As Regional Director of Operations for a home care company, J’non was ultimately responsible for the operations of several branch agencies. She completed billing audits, supervised personnel, handled employment issues and trained managers. Part of her responsibilities have included risk management, acting as Compliance Officer, development of policies and forms, survey compliance, appeals of Medicare denials, writing Corrective Action Plans, start-ups of parent and branch agencies, consulting with agencies on a variety of subjects and education of staff. J’non is certified as a Homecare Coding Specialist-Diagnosis (HCS-D), in hospice (HCS-H), in compliance (HCS-C), Certified in OASIS competency, COS-C, and is an AHIMA approved ICD-10-CM trainer. She is also a wound care certified (WCC) practitioner through WCEI. J’non is also on the board of Home Care Directions, and is a frequent contributor, along with an expert on Beacon’s Ask an Expert Panel. J’non has also been a contributor to the Decision Health Publication, The Diagnosis Coding Pro, and Eli’s Newsletter. She has presented several webinars, and has been a national speaker several times on varying subjects.
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