Dec. 2015
Are You Ready for the Two-Tiered Payment for Hospice Home Care? (Final Rule Part 1 of 2)

Published in the Federal Register on August 6, 2015, the Centers for Medicare & Medicaid Services (CMS) FY 2016 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements) Final Rule (CMS-1629-F) encompasses payment rates, non-hospice spending, diagnosis coding on claims, and quality reporting and compliance. The final rule reflects the ongoing efforts of CMS to support hospice payment reform. Simione Healthcare Consultants has prepared a two-part overview to help hospice organizations prepare for key changes, which will be effective January 1, 2016.  The focus of this first article is on the change to a two-tiered payment model for routine hospice home care effective January 1, 2016.  Key areas include the implications for billing and claims processing, and the potential challenges expected with this new model for hospice payment.

Hospice Wage Index and Payment Update
This is the first major update for the hospice wage index since CMS introduced a new methodology in 1998. The year 2016 marks the last year of seven-year Budget Neutrality Adjustment Factor (BNAF) phase-out, and includes a market basket increase of 2.4%, negative productivity adjustments of .5% and .3%, requirements for hospice quality reporting, and changes to the Core-Based Statistical Area (CBSA) geographic designations. The net increase for FY 2016 is 1.6% calculated as follows:  2.4% less (0.5) less (0.3) equals 1.6%. 

Give Your Agency a Gift: Set Compliance Goals for 2016

During the holiday season, many of us reflect on the passing year and assess whether we met our desired accomplishments -- regarding health, happiness or a sense of peace in our lives or families. Likewise, in business, we ask ourselves the same. Did we achieve our patient care goals? Did we mitigate financial risk? Have we cultivated a culture of ethics and compliance in our agency?

Now is the time to set compliance goals for the New Year. Whether you will be assessing your current ethics and compliance program or developing a program from scratch, start fresh and resolve to set new goals. Simione Healthcare Consultants is available to help you set a course.

The healthcare compliance climate continues to heat up with over $3 billion expected in government recoupments in 2015. In November 2015, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) published the Work Plan Fiscal Year 2016. This Plan summarizes areas of OIG focus by provider type. The OIG will spend extraordinary resources in auditing and investigating Medicare/Medicaid certified providers for past and new or revised initiatives.
Educational Opportunities 

February 5, 2016 @ 11 AM-1 PM Eastern
Manage and Improve Hospice Operations Through Metrics
Presenters: Lisa Lapin, Principal, and Kim Skehan, RN, MSN, Senior Manager, Simione Healthcare Consultants


Save the date for new and improved training to accelerate your results in sales and sales management. 

Day 1 - 8:30 am-5:30 pm
Day 2 - 8:30 am-3:30 pm

1-2 attendees $849 per student
3 or more attendees $749 per student

We also offer on-site training for 6 or more students at $749 per student, plus travel and expenses.

For more information, call 800-949-0388.

Square One Boot Camp and 
Sales Management Workshop 
will be held:

February 9-10, 2016 
Springhill Suites - Las Vegas Convention Center 
Las Vegas, NV

March 8-9, 2016
Hyatt Place Southpoint
Durham, NC

May 18-19, 2016
Hyatt Place Downtown
Nashville, TN

   To register, visit
Sales Leadership Summit
September 2016 (TBA)
Las Vegas, NV

Jan 19-21
The 14th Annual Northeast Home Health Leadership Summit, The Colonnade Hotel, Boston, MA
Jan 22
Health Care Compliance Association Regional Annual Conference, Hilton Garden Inn, Atlanta
Jan 28Minnesota HomeCare Association The Future of Home Care Conference & Technology Expo, Ramada, Bloomington, MN         Keynote:  Robert Simione, Managing Principal
Feb 6-9Lincoln Healthcare Home Care 100 Executive Management Conference, Lost Pines Resort & Spa, Austin, TX 
Feb 17-18
Texas Association for Home Care & Hospice Winter Conference, Intercontinental Hotel, Dallas TX
Feb 22-24American Health Lawyers Association Long Term Care & the Law Conference, Loews Portofino Bay Hotel, Orlando, FL
Apr 4-5March on Washington, National Association for Home Care & Hospice (NAHC), Mayflower Hotel, Washington, DC
Apr 6-8
Visiting Nurse Associations of America (VNAA) Annual Meeting, Hyatt Regency, Miami, FL
Apr 21-23
31st Annual Management and Leadership Conference, National Hospice & Palliative Care Organization (NHPCO), Gaylord National Resort & Convention Center, National Harbor, Maryland

Financial Monitor New Logo
Leading Industry Benchmarks
Quarterly cost analysis and agency comparisons to guide decision-making and help increase profitability
Billing, Coding &
OASIS Review

Outsourced services to accelerate the revenue cycle and help agencies focus on patient care 
Interim Management Services
Seasoned executives to support smooth transitions in operations and at your leadership table

Founded in 1966, Simione™ Healthcare Consultants provides comprehensive business solutions for home health and hospice in the areas of finance, operations, cost reporting, compliance and risk,  sales and marketing, information technology, and mergers and acquisitions.  Simione's experts and tools support performance improvement across the healthcare continuum, engaging hospitals, health networks and agencies to improve quality, reduce costs, and minimize risk for more effective delivery of patient care.