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 CMS Releases Final Rule on 2015 Home Health PPS Rates

Physician narrative eliminated for face-to-face requirements


CMS released the final rule on the 2015 Home Health PPS Rates on October 30, including several slight improvements over the proposed version. The most positive determinations for the home health industry include changes to the face-to-face requirements and modifications on the therapy assessment requirements. Additional determinations were made regarding OASIS submissions, speech-language pathologist qualifications, civil monetary penalties for Conditions of Participation violations, and recertification requirements that will increase the number of face-to-face situations. 


Following a more detailed review of the 250-page rule, Simione Healthcare Consultants will issue additional updates in newsletter articles and other communication.  If you have questions regarding these and other related determinations, please contact us at 844.215.8820 or

  Review Key Determinations or Read the Final Rule >>


Building a Referral Process that Delights the Customer


In the world of home care and hospice, the most successful teams have learned to live by "It's not about us, it's about them."  This outward focus on the customer, coupled with high-quality services, is one hallmark for differentiating a modern post-acute care agency from its competition.


According to Katherine Northcutt and Kara OsborneSenior Managers, Simione Healthcare Consultants, three key strategies for driving such excellence in customer service include:
  • Achieving accuracy and compliance in the referral process
  • Maintaining a sense of urgency and assisting families with barriers to care
  • Executing agency-wide customer service procedures and continually monitoring progress 

Accuracy in Referrals


Without the correct information at the time of referral, agencies may be compromising their regulatory compliance. Key factors include the order for care, a certificate of terminal illness (for hospice), consents and other legal documents. To ensure quality of care, additional information is helpful such as the patient's recent history and physical examination, medications, and equipment needs. It is also important to address the patient and family expectations for care. From a financial perspective, accuracy pertains to insurance verification/pre-certification, face-to-face requirements, and consent information.


Northcutt says attention to accuracy also affects business development activities. "Agencies should develop a process to evaluate reasons why a patient was ultimately not admitted for care, information about referral sources, how patients/families heard about their organizations, and the impact of each team member's activities," she explains.  

Stay Current with Industry Trends, Rules and Findings

Simione Healthcare Consultants is committed to helping home care and hospice teams improve patient care and accelerate their business performance.  Join us for one of our free upcoming webinars:

December 2 (Affiliations)
January 14 (Compliance & Risk)
February 10 (Cost Reporting)

View the schedule and register now or call 844.215.8822.
Is Outsourcing the Answer for Billing & Coding Efficiency?

Is your cash flow sluggish due to an increased DSO, issues with commercial insurance collections, or a periodic coding backlog?  With services for billing, coding and OASIS quality review, Premier Returns is designed to reduce the administrative burden and optimize the revenue cycle to improve financial performance for home health and hospice agencies. For more information, call 888.345.3947 or visit
Real-Time Benchmarking Promotes Better Decisions

The Simione Financial Monitor provides the industry's only real-time national benchmarking tool to compare agency performance across the nation. In 2013, home health and hospice agencies using the Simione Financial Monitor for the full year achieved, on average, an increase of 2 percentage points in gross margin. For more information, call 844.215.8826 or visit