Study: Increase Patient Activation To Cut Costs & Improve Outcomes

Increased levels of patient engagement through patient activation may improve outcomes and lower healthcare costs, according to a new study published in Health Affairs. Researchers analyzed patient activation levels for more than 32,000 adult patients at Minnesota’s Fairview Health Services under the Patient Activation Measure, a “metric used to quantify a person’s knowledge, skills, and confidence in managing one’s own health and healthcare” on a scale of one to four. Researchers found patients with higher levels of activation demonstrated nine out of 13 improved healthcare outcomes. Lower activation levels were associated with significantly reduced chances of positive outcomes for seven of 13 measures compared to patients who remained at level four. The research team also found activation had similar effects on billed costs. Patients with the highest levels of activation had projected costs 31 percent lower than those at the lowest activation levels. Additionally, costs increased or decreased as patients’ activation levels changed.

Click here to read more.

Attention Hospices: CMS Releases Spreadsheet, Instructions For Self-Calculation Of Aggregate Cap

As part of the FY 2015 final hospice payment rule, all hospices must self-calculate their aggregate cap and submit them to their Medicare Administrative Contractor (MAC) within five months of the close of the cap year or risk suspension of payment. A final determination of a hospice’s aggregate cap liability will be calculated by the hospice’s MAC at a later time. On Monday, CMS released a spreadsheet and instructions for use by hospices for self-calculating their 2014 aggregate cap. The release of the spreadsheet had previously been delayed as CMS and HHS resolved the most appropriate method for addressing the 2% sequester as part of the overall cap determination. CMS is not requiring that a hospice take the sequester into consideration as part of its initial cap self-calculation. Instead, the hospice’s MAC will incorporate the sequester as part of the final cap liability determination at a later date.

Hospices should anticipate that their MACs will be circulating the pro-forma spreadsheet and instructions for self-calculation of the aggregate cap in the very near future – along with details as to where hospices should send their cap spreadsheets and any overpayment. In order to complete the spreadsheet, hospices should secure information from the Provider Statistical & Reimbursement Report (P S & R) system. However, due to CMS transitioning the P S & R application from the IACS system to the EIDM system, providers have been unable to register to secure access to the P S & R.

Palmetto GBA has issues letters to its hospice providers with the data that will be needed to complete the cap self-calculation. Palmetto has also posted additional information regarding the cap self calculation and submission. Click here to see it.

It is NAHC’s understanding that while neither NGS nor CGS plan to issue letters with the P S & R data needed to self-calculate the cap on a jurisdiction-wide scale, both will still consider requests from individual hospice providers for the necessary P S & R information on a case-by-case basis. NGS and CGS are expected to post additional information on their websites in the near future.

CGS hospice providers who do not have access to their P S & R reports may submit a request to CGS for the cap data by contacting the CGS General Provider Contact Center at 877-299-4500 (select Option 1) and a referral will be made to the CGS Provider Audit department.

NGS providers who do not have access to their P S & R reports may submit an email requesting the information to PS&R@anthem.com.

Click here for information from NAHC, including CMS’ instructions for self-calculation of the aggregate cap.

CMS Report: Healthcare Industry Makes “Clear Progress ” In Triple Aim Measures

According to a new report from CMS, the country’s healthcare system has made “clear progress” in improving its delivery of the “Triply Aim” of improved care, improved health and reduced costs. Of 119 publicly disclosed performance rates for seven quality reporting programs, 5 percent improved between 2006 and 2012. In addition, approximately 35 percent of these measures were classified as high-performing, or had performance rates exceeding 90 percent. The report also found improvements in other areas, including inpatient health failure measures and inpatient hospital surgical process measures. Over the study period, racial and ethnic disparities in care also decreased and improved most among Hispanics, blacks and Asians.

Click here to see the report.

Click here to read more.

CMS Posts Proposed Revisions To The Hospice Cost Report For Hospital-Based Agencies

CMS has recently posted the proposed revisions to the hospital-based hospice costs report. Click here to see them.

Last month, CMS published notice in the Federal Register that proposed revisions to the Hospital/Hospital Health Care Complex Cost Report will be made available for review, and provided a 60-day period for submission of public comments on the changes. Once the 60-day comment period closes, it is expected that the agency will announce a second, 30-day public comment period. CMS is now determining whether to extend its comment period, which is scheduled to remain open until April 7.

NAHC and its affiliate, the Hospice Association of America (HAA) is planning to submit comments on the proposed revisions.

CMS has been revising cost reporting requirements for hospices in an effort to secure more detailed data from hospice programs to support payment reform. The first set of revisions (applicable to freestanding hospices) greatly expanded reporting requirements and became effective with cost reporting years beginning on or after October 1, 2014.

Once CMS reviews the public comments, it will issue final revisions to the Hospital/Hospital Health Care Complex Cost Report as a regulatory transmittal. The comment process is expected to take a minimum of three months.

Click here to read more.

Tiptastic Tuesday: ICD-10 Acknowledgement Testing Week Is This Week!

We would like to remind trading partners, billing services, software vendors, and clearinghouses that ICD-10 Acknowledgement Testing Week is this week, March 2-6, 2015. This testing week allows CMS to analyze testing data. Registration is not required for Acknowledgement Testing Week.

Click here for more information.

Home Health Care Planning and Improvement Act Reintroduced In Senate

The Home Health Planning Improvement Act of 2015 (S.878) was recently introduced in the Senate. The bill seeks to allow healthcare professionals (other than physicians) sign home health plans of care. S.578 will allow physician assistants (PA), nurse practitioners (NP), clinical nurse specialists, and certified nurse midwives to order home health services for Medicare beneficiaries. NPs, PAs, and clinical nurse specialists are currently unable to order less costly and less intrusive home healthcare services, although they are able to perform many other services for Medicare beneficiaries. In order to see these medical professionals as primary care providers, seniors and disabled citizens often require an extra office visit with an unknown physician. The extra visit leads to an extra administrative and paperwork burden and creates an unnecessary step that fails to recognize current training and scope-of-practice guidelines, according to NAHC. As a result of this requirement, patients in need of home healthcare are either place in more expensive care settings or experience delay in receiving the care they need. NAHC strongly supports S.878 and encourages its members to contact their lawmakers to urge them to support the legislation.

Click here to read more.

 

Monday Morning Recap

The HMS Healthcare Management Solutions Monday Morning Recap reviews some of the top stories and healthcare highlights you may have missed last week.

• CMS: More Additions & Rebasings Of Nursing Home Ratings To Come
• Reminder: ICD-10 Acknowledgement Testing Week Is March 2-6, 2015
• NAHC Adds ICD-10 Resource Page To Its Website
• Several States No Longer Plan On Expanding Medicaid
• NAHC: MedPAC Discusses Inclusion Of Hospice In Post-Hospital “Transfer” Policy
• Measure Applications Partnership, Coordinating Committee Conference Call Today