These changes are in addition to the recently postponed Home Health Conditions of Participation (CoPs), which go into effect in January, 2019. Starting January 1st, 2020, the Home Health Prospective Payment System (HH PPS), which proposes case-mix methodology refinements to the rule released last year for the Home Health Groupings model (HHGM) will have a significant change in reimbursements you might receive. The Meaningful Measures’ initiative represents a new approach to quality measures that foster operational efficiencies, and will reduce costs of collection and reporting during quality measurement.
QAPI, EHR Impact, HHA Admin Impact, Data Submission
Unit of payment updated from 60-day to 30-day episode of care
Change in the number of states and the weightage
Home Infusion therapy under Medicare HH benefit
Changes in a few quality measures
Streamline exchange of information in the HH space
Provider and billing workflows need to be redefined/tweaked and taken into account the changed criteria/parameters to trigger right actions for timely & accurate payments.
HHGM information to be part of structured document (CCDA) using DIRECT or FHIR (APIs)
Apart from collecting the right OASIS information, have HHRG auto calculated with validations around any post visit missing information
Restructure the historical mess using the new CMS initiative, Data Element Library (DEL) & effortlessly submit data through PAC assessment when it comes.
Track of all the TOB, patient status (FL 17), claim adjustments, & billing errors by the RC, immediate fixes can be done and RAP/claim can be re-submitted.
Track patient progress, have the management at HHAs track measurable outcomes & pull a report of an event if required.
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