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Simione Healthcare Consultants led four sessions at the NHPCO's 29th Management and Leadership Conference: Leading and Mobilizing Social Changes for 40 Years, held on March 27-29, 2014 at Gaylord National Harbor Resort & Convention Center in Maryland.  We are pleased to offer this summary and look forward to working with you on your hospice performance improvement goals.  



Financial Monitor New Logo  
April 2, 2014 

3-4 pm EDT    




A Solution for Rebasing "Madness" 


Hospice Cost Report Reform: Ready or Not?


Regardless of where a hospice may be located, its size, referral volume or available technology, best practices in the management and support of terminally ill patients are the same.  Cost report reform also applies equally to hospice organizations in every market throughout the nation, because the Centers for Medicare and Medicaid Services (CMS) has issued proposed new requirements to ensure that accurate and complete information is collected and reported regarding the clinical and financial activities that validate appropriate reimbursement for hospice care.


According to Lisa Lapin, Principal at Simione Healthcare Consultants, many providers in the hospice industry have not recognized the importance of filing an accurate cost report - even though CMS has confirmed that many hospice cost reports are unusable for analysis due to missing or unusual data.  "While there is currently no monetary settlement to penalize hospice providers for inaccurate cost reporting, CMS has issued a reformed hospice data collection  methodology to more closely understand resource consumption with the intent to reform hospice reimbursement.  In short, it will expand data collection efforts by CMS," Lapin says.


The Admission Decision:  Who's on First?


When it comes to hospice care, "making it easy" for patients and families requires vigilant attention to an admission process that is facing both internal and industry pressure to "get it right" the first time. 

Julia Maroney, RN and Ruth KV Recchia, RN work with hospice teams across the nation to help them understand the current environment of scrutiny, and to implement best practices for the admission process with 3 goals in mind:  improving decisions regarding eligibility, reducing organizational risk, and enhancing communication for better patient care.


Hospice Referrals Depend on Each Physician's Knowledge, Advocacy and Practices


While hospice care can be requested by anyone, a patient's physician remains a key resource where authority, trust and expertise can make all the difference in making a hospice referral a timely, supportive and beneficial experience for both patient and family. For this reason, Mike Ferris, Principal, Simione Healthcare Consultants, tells hospice teams, and specifically those working in sales, to examine each physician's feelings about hospice, knowledge of hospice, and patient management practices.



Accelerate Referrals by Focusing on Three Customer Service Goals


When a patient is referred for hospice services, several people and organizations are typically involved in a flurry of activity to support the admission process. In order for this process to work effectively, Katherine Northcutt, RN says that the referral and admission process must focus on communication and a sense of urgency to provide the patient with an experience that eliminates common barriers to care.  On the business side, the first goal of the referral process should be accuracy to meet all regulatory requirements and maintain optimal reimbursement to keep hospice organizations thriving to meet future community needs.  The challenge is to improve the accuracy while maintaining that critical sense of urgency.