Tiptastic Tuesday: CMS Posts CAHPS Hospice Survey Info

CMS has issued two new items on its HOSPICE CAHPS WEBSITE related to the CAHPS Hospice Survey Vendor Authorization and a CAHPS Hospice Survey Fact Sheet.

The following are CMS’ most recent CAHPS announcements:

URGENT: CAHPS Hospice Survey Vendor Authorization Form Due 

The deadline for hospices to complete and submit the CAHPS Hospice Survey Vendor Authorization Form is May 1, 2015. Hospices must authorize an approved CAHPS Hospice Survey vendor to submit data on their behalf for the 2015 administration of the CAHPS Hospice Survey. Please click on Technical Specifications to access the CAHPS Hospice Survey Vendor Authorization Form.

CAHPS Hospice Survey Fact Sheet 

The CAHPS Hospice Survey Fact Sheet located on the CAHPS Home Page contains an overview of the CAHPS Hospice Survey program, information regarding the CAHPS Hospice Survey measures and information for survey vendor participation. 

Click here for additional information on the CAHPS Hospice Survey

Click here to read more from NAHC.

Tiptastic Tuesday: 5 Changes To Help Medicare ACOs Thrive

In order for the Medicare Shared Savings Program to reach its full potential, some key changes must be made, according to the authors in a recent Health Affairs blog post. Medicare ACOs have made progress on care quality and patient experience, however, only 1 in 4 MSSP ACOs have cut spending enough to share in overall savings.

According to authors in Health Affairs, the Medicare Shared Savings Program needs to make the following changes to truly thrive:

  • Increased certainty: A major issue with MSSPs is uncertainty. In order to correct this, CMS should transition to a benchmark calculation formula that combines ACOs’ historical spending and regional spending to eventually transition to a benchmark based completely on regional spending.
  • Clear definition of the transition away from fee-for-service: CMS should drive the transition with incentives greater than those for fee-for-service for organizations that demonstrate reduced costs and improved quality.
  • Alignment of MSSP with other Medicare reimbursement programs: In order to get MSSP and other Medicare alternative payment models on the same page, the authors recommend risk adjustment calculations, reporting mechanisms and requirements, and consistent quality measures.
  • Patient engagement: ACOs need more support to communicate and engage with their patients. The authors suggest expanding CMS’ pilot program for Pioneer ACOs’ “attestation models.”
  • Use of pointers from commercial ACOs: Many ACOs in the private sector have seen more success than those under Medicare by shifting away from fee-for-service with limited financial risk. CMS “should seek to reinforce those successful steps.”

Click here to read more.

Tiptastic Tuesday: Top 3 Data Security Issues For Physician Practices

Healthcare technology is starting to play a bigger role in patient care, greatly increasing the chances of patients’ protected health information (PHI) to be compromised. This means that it’s more important than ever for practices to keep their eyes on security trends to stay in compliance and avoid data breaches.

Here are three of the top issues practices will face this year relating to data security:

  1. More laws regulating data sharing with business associates (BAs). Trusting BAs with sensitive patient data is necessary to a practice’s operations. However, breaches can easily occur if PHI isn’t shared securely. This year, there will be increased legal scrutiny for these relationships. Make sure you have language in your contracts discussing the specifics of your associates’ security protocol.
  2. Financial woes from breaches. If practices don’t invest the money into resources needed to keep PHI safe, they will be paying for it later. With every new data breach, there will be higher fines and more lawsuits from patients and other affected parties. It will be much less costly to budget for data encryption and other security features than to face these exorbitant fees.
  3. Seamless data sharing. This year, there will be more pressure on practices to have electronic health records (EHR) systems that easily and securely share PHI with other healthcare providers. Be sure to discuss the possibility of such interoperability with your EHR vendor.

Tiptastic Tuesday: How To Stay In Compliance & Avoid Data Breaches

Healthcare technology is starting to play a bigger role in patient care, greatly increasing the chances of patients’ protected health information (PHI) to be compromised. This means that it’s more important than ever for practices to keep their eyes on security trends to stay in compliance and avoid data breaches.

Here are three of the top issues practices will face this year relating to data security:

  1. More laws regulating data sharing with business associates (BAs). Trusting BAs with sensitive patient data is necessary to a practice’s operations. However, breaches can easily occur if PHI isn’t shared securely. This year, there will be increased legal scrutiny for these relationships. Make sure you have language in your contracts discussing the specifics of your associates’ security protocol.
  2. Financial woes from breaches. If practices don’t invest the money into resources needed to keep PHI safe, they will be paying for it later. With every new data breach, there will be higher fines and more lawsuits from patients and other affected parties. It will be much less costly to budget for data encryption and other security features than to face these exorbitant fees.
  3. Seamless data sharing. This year, there will be more pressure on practices to have electronic health records (EHR) systems that easily and securely share PHI with other healthcare providers. Be sure to discuss the possibility of such interoperability with your EHR vendor.

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.

Tiptastic Tuesday: 5 Ways To Improve The Palliative-Care Patient Experience

According to new research published in the Journal of Pain and Symptom Management, palliative care providers can significantly reduce their patients’ risk of unnecessary physical and emotional discomfort if they meet 10 quality measures. The research is the result of a two-year project that began with a list of 75 quality indicators which the research team reduced to 10.

Of the 10 recommendations, five include:

  1. Hospice and palliative care patients should receive comprehensive physical, social, spiritual, functional, and psychological assessments soon after admission.
  2. Seriously ill patients should be screened for symptoms, including pain, nausea, and shortness of breath as part of their admission visits.
  3. Patients whose illnesses are advanced or life-threatening and whose screening indicate shortness of breath should develop a plan for managing it.
  4. Seriously ill patients should document their life preferences regarding life-sustaining care.
  5. Providers should give hospice/palliative care patients or their families a relevant survey to assess their care experience.

Click here to read more.

Tiptastic Tuesday: Improve Practice Documentation

Insufficient documentation is one of the top issues leading to overpayments with payors on the lookout for any missing info in patients’ records. The biggest reason why provider documentation doesn’t hold weight usually has nothing to do with the codes selected and everything to do with a missing signature.

All medical notes must have an authorized signature. If any note in the medical record does not have an authorized signature, it will not be counted as valid documentation for the encounter.

When you’re performing self audits of your practice’s claims, make sure provider signatures are exactly where they should be. If a signature is missing during a self audit, you cannot simply have the provider add it. Signatures listed after the fact raise red flags for payors. Instead of adding signatures in, have your provider fill out and sign an attestation statement saying that he or she is the person who entered the data in the medical record for the patient on that date, and that all the information entered is valid. Keep this statement with the documentation for the encounter so it is easily accessible.