Globally, the ICD-10 Classification System improves documentation of the increasing complexity of healthcare, specifically demonstrating the clinical presentation of each patient.Read More
Welcome to the HealthPRO® Heritage Blog
When thinking about the future of skilled nursing and therapy services one quote comes to mind: “The biggest risk a person can take is to do nothing.” (Robert T. Kiyosaki) This has never been more true.
Under RUGS-IV, therapy utilization, by and large, has been the main driver for Medicare Part A reimbursement. When the skilled stay is supported by therapy, justification for nursing services can be overlooked. Under PDPM, however, each discipline, nursing and/or therapy, must justify the level of services provided and the patient’s condition as coded within the medical record. Without proper coding, claims could be denied or reimbursement will not be aligned with treatments.Read More
CMS released the much anticipated Home Health Final Rule October 31. Much of the content from the Proposed Rule and the Final Rule will remain the same, with significant changes highlighted below.Read More
Imagine a world where reimbursement isn’t based on managing treatment minutes. Instead, therapists are empowered with the freedom to care for residents and drive outcomes based exclusively on clinical need. Let’s face it: Therapy services and reimbursement under PPS has not always served our industry well.
HealthPRO® Heritage experts agree: CMS’ PDPM system will breathe new life into how, when, and why therapists deliver care. We are, in fact, excited for a new world where our success will be measured by the evidence-based therapy we provide and the outcomes we achieve on behalf of our clients and patients.Read More
Since the RCS-1 Proposed Rule was released in Spring 2017, through the PDPM Final Rule and up to today, we’ve spent hundreds of hours thinking and pressure testing different ideas. We’ve had ongoing conversations with customers, colleagues, and consultants about PDPM therapy pricing. Our goal was simple: Develop a pricing approach which equally addresses and ensures the success of our patients, customers, and employees under PDPM.Read More
Step one to ensuring your facility delivers positive patient outcomes, maintains regulatory compliance, and achieves financial viability in the New PDPM World is to perform a RUGs-to-PDPM Crosswalk on all your patients.Read More
In the recently updated Conditions of Participation, CMS spells out what they expect from a QAPI program. Additionally, the final draft of the interpretive guidelines (IG) for the Home Health Agency Conditions of Participation (CoP) was released last month.
How can agencies use this already mandatory requirement to help prepare them for the expected changes coming in 2020 with the proposed Patient Driven Groupings Model (PDGM)?Read More
Success or failure for SNFs will hinge directly on hospital readmission rates (& other performance metrics, too!)
What’s This About 2% of My Revenue?Read More