Proposed policy changes for how HHAs will bill for therapy services are giving many a reason to pause and reevaluate their therapy business. Why is that?
Under the Patient-Driven Groupings Model (PDGM) proposed by the Centers for Medicare & Medicaid Services (CMS) on July 2, 2018, home health providers will no longer be able to use therapy volume as a payment rate determinant, a point that has long been a concern for the Medicare Payment Advisory Commission (MedPAC), lawmakers and industry groups alike.
“Oh no! CMS is shutting down my therapy business!”, is the reaction some agencies are having. But the intent from CMS is not to eliminate therapy payments, but to instead remove incentives for agencies to over-provide therapy. “The redesign of the home health payment system encourages value over volume and removes incentives to provide unnecessary care,” CMS Administration Seem Verma said in an agency announcement.
Making the Adjustment
While concern about payments for therapy services is understandable, we at Viscare don’t believe the changes are necessarily bad for business. We have seen, and it is widely believed, that patient care is improved when quality therapy is provided to patients immediately and over a shorter period of time. Agencies should consider that if make the prescribed policy changes and their services aren’t diminished, this would validate that agencies have been providing the right level of care to patients.
Conversely, should agencies eliminate their therapy business, or course correct in a direction that is dramatically different from what they are performing today, this would validate the MedPAC concern that therapy treatments have been over prescribed and thus agencies are committing financial abuse.
How Viscare can help you with these changes
2020 may feel like a year away, but you need to start making changes to your business now in order to avoid costly disruptions when these proposed changed come into effect. Consider that PDGM will halve the 60 day episode to 30 days, and changes in the therapy model mean that HHAs will need to offer quality within 30 days instead of 60. This change will be a challenge for an administrative staff to manage and the difficulties of figuring out the best course of action cannot be left to be addressed at the last minute.
With Viscare’s “Agency Aid” software and “Clinician App”, HHAs will achieve new levels of efficiency with automation that seamlessly directs therapists to the right patient. Now missed calls are eliminated because patient visit results are tracked in real time, and should there be a chance of a miss, the call is automatically rerouted to the next best therapist. And finally, all the call records are updated in real time, giving your office staff the opportunity to focused on managing new submissions, monitoring the quality of calls, and ultimately growing your business.
Why not contact us today and let’s discuss how Viscare can help you efficiently staff your business, protect your revenue, and grow your business. You can contact us by email at: firstname.lastname@example.org