The Impact of Quality Reporting on Star Ratings

A tightly interwoven loop illustrates the impact of quality reporting on star ratings ... and the importance of the relationship between the two. Star ratings encourage providers to strive for higher levels of quality. They support consumers’ health care decision-making by providing easily recognizable differences in quality when selecting a health care provider. The higher the... Continue Reading →

RCD … Starts December 10: Except When It Doesn’t

Let's discuss the RCD implementation delay. The Review Choice Demonstration (RCD) for Home Health Services was scheduled to begin in Illinois on December 10, 2018. Numerous CMS webinars, Palmetto GBA webinars, and a CMS Open Door Forum all said so.  However, that date seems to be a mirage, at least for the present time. Due... Continue Reading →

TPE Update: The Only Constant is Change

Yet Another Update to TPE (Targeted Probe and Educate) THIS JUST IN! (This post updates a blog written and published on 11/8/18) Medicare Administrative Contractor (MAC) CGS Administrators has just posted its first update to Targeted Probe and Educate (TPE) activity in nearly a year, and immediately updated it. Four more areas to receive additional... Continue Reading →

Cirque de Home Health: Juggling Payment Risks – TPE update

THIS JUST IN - TPE UPDATE! Medicare Administrative Contractor (MAC) CGS Administrators has just posted its first update to Targeted Probe and Educate (TPE) activity in nearly a year. Four more areas will receive further scrutiny. These TPE updates are in addition to Home Health Eligibility & Medical Necessary and Length of Stay (LOS) with... Continue Reading →

It’s Alive! The Return of Pre-Claim Review… in the Form of Review Choice Demonstration

After a pause of more than a year, CMS will soon resume the pre-claim review (PCR) demonstration project in five selected states. The pre-claim review is now called Review Choice Demonstration (RCD) for Home Health Services and there are some changes. First of all, tweaks in the new process "offer more flexibility and choice for providers,... Continue Reading →

Valuing Quality Through Care Management

Care Management ensures the quality of patient care with measurable outcomes and Quality Cycle Management (QCM) Accomplish effective Care Management by using a multi-disciplinary team to provide coordinated care for high-risk patient populations. Quality Cycle Management (QCM) lays the foundation for the agency to provide Care Management. How? Through coordinated workflow processes and operations that follow... Continue Reading →

Healthy Revenue Cycle: QIRT Financial Fit List 2018

Healthy revenue cycle is crucial to a post-acute agency's overall fitness.  This is even truer now, with the new payment model on the horizon. QIRT's financial experts have created a "fitness routine" to help strengthen your agency. Make use of QIRT's Financially Fit List for toning processes and preparing benchmarks.  What does your agency's revenue... Continue Reading →

CASPER Reports – Not as Friendly as the Ghost

... and CASPER Reports Could Be Coming Your Way. On July 9, 2018, CMS began loading into the hospice folders letters of non-compliance for agencies who failed to meet the Hospice Quality Reporting Program (HQRP) requirements. As I am sure you know, non-compliance affects your FY19 Annual Payment Update (APU). If you haven't already checked... Continue Reading →

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