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Envision Everything!

HealthPRO Heritage invites health services providers from across the spectrum of care to Envision Everything!

Envision Everything! is HealthPRO Heritage’s approach to mastering regulatory change and executing a strategic response, rather than simply focusing on the mechanics of regulatory and reimbursement changes. Envision Everything! Is a call-to-action for all healthcare providers to:

  • See every change as a step towards CMS’ ultimate plan for a future where Triple Aim and Value-Based Payment system are fully realized
  • Critically evaluate the broad implications of changes and trends while understanding how changes at one level of care impact upstream and downstream service delivery
  • Choose to see CMS changes as a catalyst, or opportunity to engineer truly meaningful solutions that will shape the future of healthcare

Apply the Envision Everything! strategy to the newly announced regulatory changes for 2022. CMS recently released significant Final Rule announcements with far-reaching implications that signal the move toward value-based care, including reimbursement changes for Remote Therapeutic Monitoring and the expansion of Transitional Care Management codes for physicians to bill concurrently with chronic care management codes. Also, the CY 2022 final rule for home health delayed the expansion by one year of Value Based Purchasing beyond the initial nine states to all states in CY 2023. Additionally, the Final CY2022 Medicare Physician Fee Schedule outlined the fee schedule featuring dramatic cuts for SNF physician visits, outpatient therapy and therapy provided by therapy assistants (versus registered therapists).

Consider the impact of these changes across the care spectrum for patients and healthcare providers alike! But do so by assessing what opportunities are created, too. In other words, be inspired to…Envision Everything!

HealthPRO Heritage experts offer up the following insight and guidance:

  • Transitional Care Management (TCM) provides SNF, Senior Living, and Home Health providers a platform for improved care coordination, meaningful collaboration, and stronger partnerships with hospital and primary care physicians. Ask HealthPRO Heritage for a “Transitional Care Management Guide” to optimize opportunities associated with leveraging TCM.
  • The ability to bill for Remote Therapeutic Monitoring (RTM) services will completely transform the patient experience. This is especially true for high acuity populations under the Senior Living and home health agencies that leverage strong collaborative partnerships with physicians to optimize the use of RTM.  
  • The 1-year delay for the Home Health Value Based Purchasing Program provides home health agencies (HHAs) the opportunity to prepare! With a potential 5% upside at stake, HHAs must become adept at mitigating hospitalization (or be subject to penalties). HealthPRO Heritage predicts this program will continue to drive down SNF rehospitalization rates and significantly change strategic alliances between HHAs, Senior Living, and SNFs to better coordinate care across the spectrum.    
  • With more reimbursable services being provided in the home setting, Senior Living providers are encouraged to Envision Everything! This trend towards home-based services is a golden opportunity for Senior Living operators who understand state regulations and licensing requirements and who are prepared to care for/admit/readmit clinically complex residents. 
  • Previous HealthPRO Heritage blogs available here review CMS’ Choose Home Care Act of 2021. Although currently in legislation, HealthPRO Heritage experts predict this signals a major regulatory and reimbursement shift in our healthcare system. (Consider that forward-thinking payers such as United Health Care already provide “bundled” payments added onto home health episodes). This critically important trend is in response to the need/expectation for SNFs, Assisted Living and Home Health providers to care for much higher acuity populations than ever before. Ask yourself, what strategies, resources, and support will help my facilities/communities/staff better manage more complex patients/residents?     
  • Be aware that Physician Fee Schedule rate cuts may change how physicians, rehab companies, and facilities with their own in-house therapy teams provide care. HealthPRO Heritage’s Envision Everything! the strategy has been to anticipate and carefully plan for the threat of reimbursement changes. Our solution: Because we value the relationships with the SNF, CCRC, Senior Living providers with whom we partner, our dedicated team designed specific strategies to minimize the impact on therapy services.  We also realize Advocacy is critical!  With a possibility of a delay or fix, please let your voices be heard! Advocate to #StoptheCuts here.

On behalf of the HealthPRO Heritage leadership, strategy, and operations teams, HealthPRO Heritage is privileged to serve the senior care industry for more than 20 years. We pledge our continued support and will offer – in services to our peers and partners – resources and industry insights with our new Envision Everything! blogs and vlogs.

Contact our Regulatory Strategy Experts here to ask questions/share insights/provide feedback. Stay tuned for more intel and advice from our Envision Everything Regulatory Experts again soon!