HOMETOWN HEALTH PEPPER REPORTS

HTH PEPPER REPORTS Information can be found:  Federal Register  Department of Health and Human Services/Office of the Inspector General.  Pepperresources.com

HTH PEPPER REPORTS What is a PEPPER report?  Program for Evaluating Payment Patterns Electronic Report  Microscoft Excel Workbook  Information from filed Medicare Claims  Compares your Hospital’s data to state and national information

HTH PEPPER REPORTS Availability:  Short Term Acute Care PPS Hospitals  Long Term Acute Care PPS Hospitals  Critical Access Hospitals  Inpatient Psychiatric Hospital  Rehabilitation Facilities 1 st Quarter – October through December 2 nd Quarter – January through March 3 rd Quarter – April through June 4 th Quarter – July through September

HTH PEPPER REPORTS  How do I use this report???  You will be able to identify the target areas that CMS looks at  You will be able to change your Utilization Review habits  You will be able to identify over or under coding

HTH PEPPER REPORTS Target Areas:  List of target areas can be found on the pepperresourse.com 29 Target areas Why focus on target Areas?  This is what CMS is looking at. This CAN and WILL affect your reimbursement!!!!

HTH PEPPER REPORTS Percentages:  Flag – at or above 80% in risk areas  Flag – lower than 20% for coding-related risk  Look at your Compare Worksheet first.

HTH PEPPER REPORTS Revenue Cycle:  Ancillary Department Managers  Patient Financial Services  HIM  Coder  Utilization Review  CNO  CFO  Compliance officers

HTH PEPPER REPORTS Revenue Cycle Meetings:  Review the PEPPER Report.  Pull reports from your HIS for validation  Review patient records

HTH PEPPER REPORTS Revenue Cycle Plan:  Identify the problem  Develop a plan  Put the plan in place  Monitor for improvement

HTH PEPPER REPORTS Example of plan:  Hospital notices their “readmission” is high.  Pull all records

HTH PEPPER REPORTS One Day Stays… Ugly words but it happens…. READ, LEARN, UNDERSTAND PEPPER REPORTS STUDY, PLAN, DEVELOP, INSTITUTE PLANS RACS ARE USING THIS DATA…. WHY SHOULDN’T YOU?