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PPS Impact Analysis
PPS 2008 Regulatory Changes
Recently, CMS released the final Home Health Prospective Payment System and
Rate Update (CMS-1541-FC). These new regulations present the most significant
changes in Medicare’s payment structure since the inception of PPS, and will go
into effect on January 1, 2008. This means that home health agencies must act
now to evaluate the impact and create a smooth transition into this new era of
Medicare PPS.
Impact Analysis
McBee Associates is the only firm offering a comprehensive impact analysis of
revenue and profitability for your agency. This claim-by-claim analysis is the
first step in a strong, proactive response to regulatory changes. And unlike
high-level overviews and data summaries, our in-depth analysis provides a total
picture of the financial impact on your agency. McBee Associates is ready to
help you forecast the financial effects your agency can expect under the new
PPS changes by repricing a representative sample of your Medicare claims
according to the new regulations. Armed with this valuable information, you’ll
be able to pinpoint the positive and negative financial issues and adjust your
agency operations —before the new regulations impact your financial health.
McBee Associates provides recommendations to improve both financial and
operational processes. Once implemented, our recommendations will improve
profitability by enhancing the positive aspects while reducing the negative
impact of the new PPS regulations. Our expert team of financial and clinical
consultants provides the support required to successfully implement these
improvements.
Strategic Discussions with Senior Leadership
Your success depends on how well senior management understands the financial
and operational impact of the new payment system on your agency. McBee
Associates’ engagements include findings reports detailing information you need
to thoroughly explain all aspects of the new PPS regulations and how they will
affect your agency. This enables you to work with senior leadership to develop
strategies that can head off any negative effects long before they impact your
operations.
Adjusting Operations to Offset Negative Financial Impacts
Improving operations can help you offset negative financial effects and
increase your overall profitability. McBee Associates provides several
operational improvement services that can increase your financial performance
while helping you deliver high-quality care.
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An Operational Assessment is the starting point for many
agencies seeking to compensate for negative financial effects of the new
regulations. The assessment focuses on the OASIS process, episode management,
scheduling, coding issues, and documentation flow.
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An OASIS Evaluation identifies weaknesses in your OASIS process
and provides recommendations for improvement. Implementing these process
improvements can help ensure that your organization is prepared for the new PPS
regulations.
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Diagnosis Coding will play a significantly larger role in the new PPS reimbursement model. McBee Associates’ certified coders can provide a coding review and staff training to address any problems identified during the review.
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OASIS Training provides your clinical staff with the knowledge and understanding necessary to accurately complete the OASIS according to CMS guidelines. Proper training can improve scoring accuracy and help ensure full reimbursement for the care you provide.
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Episode Management improvements are another way to offset the effects of PPS changes. Implementing continuous, proactive episode reviews enables staff to deliver more appropriate care, ensures appropriate utilization of visits and disciplines, and addresses problems as they arise, instead of after the fact. This can reduce per-episode costs, lead to more appropriate patient care, and ensure more accurate reimbursement.
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