FALL WEBINAR

OUR PRESENATATION WILL BEGIN IN A FEW MINTUES. LMHPCO FALL WEBINAR WELCOME OUR PRESENATATION WILL BEGIN IN A FEW MINTUES. IF YOU HAVE CALLED IN YOU MAY SEE A 4 DIGIT CODE NEXT TO YOUR NAME ON THE ATTENDEE LIST. PLEASE ENTER THE NUMBER FOLLOWED BY THE #. USING AN IPHONE? PLEASE TOUCH THE KEYPAD ICON ON YOUR PHONE AND ENTER YOUR CODE FOLLOWED BY THE #. A Q& A SESSION WILL FOLLOW THE PRESENTATION. USING THE CHAT ICON LOCATED AT THE TOP UPPER CORNER YOU MAY ENTER YOUR QUESTION. IF YOU REQUIRE ASSISTANCE DURING THE CONFERENCE PRESS *0 AND YOU WILL BE DIRECTLY CONNECTED TO THE OPERATIOR.

Medicare 2017 Wage Index Presented by LMHPCO+

LMHPCO+ DISCLAIMER The information contained in this presentation is intended for general informational purposes. Participants are encouraged to review this information and adapt to serve their individual purposes.

WHAT’S COMING? CAP YEAR CHANGES TO OCTOBER 1, 2016 THRU SEPTEMBER 30, 2017 TWO NEW QUALITY MEASURES CAP AMOUNT FOR 2017 IS $28,404.99

AND IN ADDITION DEVELOPMENT OF HOSPICE COMPARE. STANDARIZED PATIENT ASSESSEMENT TOOL. ANALYSIS OF HOSPICE DATA ULTIZATION. HOSPICE HOSPITAL MARKET BASKET @ 2.1%.

CAP YEAR CHANGE AGGREGATE CAP YEAR WILL ALIGN WITH THE FEDERAL FISCAL YEAR, OCT. 1, 2016-SEPT. 30, 2017. CAP YEAR CHANGE AFFECTS THE INPATIENT CAP AND THE AGGREGATE CAP.

METHODOLOGY OF PAYMENT IS YOUR AGENCY STREAMLINED OR PROPORTIONAL? FY 2017 IS A TRANSITIONAL YEAR FOR THE CMS HOSPICE CAP METHODOLOGY. MEDICARE MONIES RECEIVED BETWEEN 11/01/16 THRU 09/30/17 WILL BE CONSIDERED IN CALCULATING THE 2017 CAP.

2017 WAGE INDEX STREAMLINED AGENCIES WILL COUNT FIRST ELECT HOSPICE PATIENTS BETWEEN SEPTEMBER 28TH, 2016 AND SEPTEMBER 30TH, 2017. PROPORTIONAL AGENCIES WILL COUNT FIRST ELECT HOSPICE PATIENTS BETWEEN NOVEMBER 1ST, 2016 AND SEPTEMBER 30TH, 2017.

OCTOBER 1, 2017 THRU SEPTEMBER 30, 2018 AROUND THE CORNER… CAP DATES FOR STREAMLINED AND PROPORTIONAL METHODS CHANGE AGAIN. PROVIDERS WILL COUNT FOR FIRST ELECT BENEFICARIES AND RECEIVED MEDICARE MONIES WITHIN THE SAME TIME FRAME. OCTOBER 1, 2017 THRU SEPTEMBER 30, 2018

QUALITY MEASURES CMS IS DEVELOPING A HOSPICE PATIENT ASSESSEMENT TOOL. UTLIZING DATA COLLECTED FROM THE HIS AND HOSPICE CAHPS SURVEY CMS WILL HOST A MEDICARE HOSPICE COMPARE SITE SOMETIMES IN SPRING/SUMMER OF 2017. TWO ADDITIONAL QUALITY MEASURES ARE ADDED TO THE CURRENT HQRP EFFECTIVE APRIL 2017.

HOSPICE VISITS WHEN DEATH IS IMMINENT. 2017 QUALITY MEASURES HOSPICE VISITS WHEN DEATH IS IMMINENT.

TWO MEASURES MEASURE #1 INDICATOR: FOCUSES ON CASE MANAGEMENT AND CLINICAL CARE WITHIN THE LAST THREE DAYS OF THE PATIENT’S LIFE. INDICATOR: PERCENTAGE OF PATIENTS RECEIVING VISITS WHICH ARE MADE BY AN RN, PHYSICIAN, NURSE PRACTITIONER, OR PHYSICIAN’S ASSISTANT.

MEASURE #2 GAUGES THE ADAPTABILITY OF THE HOSPICE PROVIDER TO INDIVIUALIZE CARE WHICH ADDRESSES THE PATIENT’S, FAMILY’S , AND CAREGIVER’S PREFERENCES AND GOALS THAT CONTRIBUTE TO OVERALL WELL BEING OF THOSE INVOLVED IN THE PATIENT’S LIFE WITHIN THE PATIENT’S LAST SEVEN DAYS OF LIFE. INDICATOR: PERCENTAGE OF PATIENTS RECEIVING AT LEAST TWO VISITS FROM THE MEDICAL SOCIAL WORKER, CHAPLAIN OR SPIRITUAL COUNSELOR, OR CNA.

COMPOSITE PROCESS ULTIZING THE CURRENT HQRP* CMS WILL CALCULATE EACH PATIENT’S MEASUREMENTS AND AGGREGATE FINDINGS INTO ONE SCORE FOR THE HOSPICE. (*PAIN SCREENING AND ASSESSMENT, DYSPNEA, PATIENTS USING OPIODS WITH A BOWEL REGIMEN, TREATMENT PREFERENCES, AND BELIEFS AND VALUES) DATA COLLECTION TO BEGIN APRIL 1, 2017. UNMET COMPLAINCE THRESHOLDS FOR CMS HIS RECORD SUBMISSION WILL BE COSTLY TO THE PROVIDER.

*Provider reimbursement will be financially penalized.. HOSPICE HAS A 30 DAY TIME FRAME TO SUBMIT HIS RECORDS. Calendar Year 2016 70% COMPLIANCE THRESHOLD NON-COMPLIANCE FY 2018* Calendar Year 2017 80% COMPLIANCE THRESHOLD NON-COMPLIANCE FY 2019* Calendar Year 2018 90% COMPLIANCE THRESHOLD NON-COMPLIANCE FY 2020* *Provider reimbursement will be financially penalized..

HOSPICE COMPARE HIS AND HOSPICE CAHPS DATA TO BE USED. CMS WILL REPORT DATA RECEIVED FOR LAST QUARTER 2014 AND FIRST THREE QUARTERS OF 2015. HOSPICES WITH ESTABLISHED REPORTABLITY OF THE MEASURES, 71% TO 90%, MAY PARTICIPATE IN PUBLIC REPORTING, DEPENDING ON THE MEASURE.* (*Hospices should check for accuracy of their CASPER feedback reports prior to publicly reporting.)

MEDICARE. GOV A CONSUMER MAY FIND HOSPICE CARE @ THE “MEDICARE.GOV “ WEB SITE. HOSPICES MAY BE LOCATED BY ZIP CODE OR CITY SERVED. QUALITY MEASURE DATA WILL BE AVAILABLE FOR THE CONSUMER ON ANY PARTICULAR HOSPICE AGENCY.

HOSPICE PATIENT ASSESSMENT INSTRUMENT CMS IS IN THE DEVELOPMENT STAGES OF DESIGNING AN INSTRUMENT TO EVALUATE CONCURRENT PATIENT HOSPICE RECORDS. THE INSTRUMENT WOULD PROVIDE A “MORE ROBUST DATA COLLECTION” THAT WOULD PROVIDE IN TIME DOCUMENTATION REFLECTIVE OF THE HOLISTIC APPROACH TO END OF LIFE CARE. FROM THE INSTRUMENT PROVIDERS MAY SEE FURTHER DEVELOPMENT OF QUALITY MEASURES IN THE FUTURE.

HOSPICE UTILIZATION MEDICARE HOSPICE HAS INCREASED FROM 513,000 PATIENTS IN 2000 TO 1.4 MILLION IN 2015. COSTS FOR THESE TIME PERIODS HAVE INCREASED FROM $2.8 BILLION TO $15.5 BILLION. THE LEADING HOSPICE DIAGNOSIS AS OF 2015 IS ALZHEIMER’S, FOLLOWED BY CHF, LUNG CANCER, AND COPD. WITH MOUNTING HOSPICE COSTS HOSPICE PROVIDERS MUST JUSTIFY THE PATIENT’S TERMINAL PROGNOSIS AND RELATED CONDITIONS. DATA REPORTING TO CMS IS OUR BEST METHOD TO COMMUNICATE TO CMS WHAT WE DO AND HOW WE DO IT.

WHAT DOES CMS EXPECT FROM PROVIDERS? ALL DIAGNOSES BE LISTED ON THE CLAIM FORM, WHETHER RELATED OR UNRELATED. ACCURATE, ICD-10 CODING VALIDATES YOUR PATIENT’S TERMINALILTY TO CMS. THE HOSPICE MEDICAL DIRECTOR DEFINES RELATED/UNRELATED HOSPICE DIAGNOSES/CONDITIONS.

HOSPICE REFORM IS A PART OF THE ACA. CMS DATA MONITORING HOSPICE REFORM IS A PART OF THE ACA. CMS CONTINUES TO MONITOR DATA: PRE HOSPICE SPENDING. NON-HOSPICE SPENDING. LIVE HOSPICE DISCHARGE RATES. SKILLED VISITS IN THE LAST DAYS OF LIFE.

“QAPI” THE LIVE DISCHARGE RATE LMHPCO+ SUGGESTIONS “QAPI” THE LIVE DISCHARGE RATE ASTUTE INVESTIGATION OF HIGH LIVE DICHARGE RATES. DEVELOPMENT OF RESOURCEFUL METHODS AND REVISING AS NEEDED. ONGOING MONITORING AND FLEXIBITY TO REDRESS APPROACHES. ACKNOWLEDING ABOVE NATIONAL AVERAGE OF LIVE HOSPICE DISCHARGES AND A HOSPICE TAKING ACTION TO REDUCE THEIR AGENCY’S HIGHER THAN NORMAL RATES MAY EFFECTIVE SHOULD CMS/OIG INQUIRE.

LMHPCO+ SUGGESTIONS HOSPICE DOCUMENTATION REFLECTIVE OF THE PATIENT’S LAST FEW DAYS OF LIFE. HOSPICE CARE PLAN REVISION TO REFLECT SYMPTOM AND PAIN MANAGEMENT, PATIENT AND FAMILY EDUCATION, FREQUENCY OF VISITS INCREASED, ETC. PROPER REPORTING OF MEDICATIONS USED IN THE LAST FEW DAYS OF LIFE WHEN BILLING. UPDATING RELATED CONDITIONS (DIAGNOSES) IF APPROPRIATE.

FISCAL YEAR 2017 WAGE INDEX BEGAN OCTOBER 1, 2016. NEW CBSAs CODES INCLUDING RURAL AREAS. WAGE INDEX VALUES ARE FOUND AT THE CMS WEBSITE. AN INCREASE IN HOSPICE RATES OF 2.1%. HOSPICES WHO FAILED TO SUBMIT QUALITY DATA ARE PENALIZED WITH A REDUCUTION OF MEDICARE MONIES RECEIVED BEGINNNG IN NOVEMBER.

CAP SELF REPORTING CMS REQUIRES PROVIDERS TO SUBMIT THEIR CAP REPORT NO LATER THAN 5 MONTHS AFTER THE CAP YEAR AND NO SOONER THAN 3 MONTHS AFTER THE CAP YEAR CLOSES. MACs (PALMETTO GBA) WILL ANNOUNCE THE DUE DATE FOR THE REPORTING OF THE SELF CAPS WITHIN THE NEXT FEW MONTHS.

LMHPCO+ SUGGESTIONS ENROLL IN LISTSERV WITH PALMETTO GBA. UTILIZE YOUR CASPER REPORTING FINDINGS. STAY IN INFORMED VIA LMHPCO’S UPDATES. READ THE MONTHLY LMHPCO JOURNAL. UTILIZE THE BENEFITS OF YOUR LMHPCO MEMBERSHIP. UTILIZE LMHPCO+

LMHPCO+ AFFORDABLE ACCESSIBLE WE TAILOR YOUR OPPORTUNTIES TO YOUR AGENCY’S NEEDS.

LMHPCO+ CONSULTANTS ARE LOCAL PEOPLE. CONSULTANTS HAVE SERVED OVER 40+ YEARS IN THE HOSPICE FIELD. CONSULTANTS WELL VERSED IN FEDERAL CoPs AND LA AND MS MINIMUM STANDARDS.

LMHPCO+ YOUR FEEDBACK IS VITAL TO ENSURE LMHPCO IS MEETING THE NEEDS OF OUR MEMBERSHIP. FEEDBACK CAN BE SUBMITTED TO LMHPCO+ TO ann@lmhpco.org or martha@lmhpco.org. OR BY CALLING LMHPCO+ AT 888-546-1500. CHOOSE OPTION #5 FOR MARTHA OR #6 FOR ANN.

LMHPCO+ THANK YOU! ANN MARTHA