Sessions
Tuesday, June 2
8:00am - 12:00 pm: Preconference
2015 Jurisdiction 11 (J11) Home Health Medicare Workshop Series – The Golden Years – Medicare at 50!
This workshop is designed for home health providers and their staff to
equip them with the tools they need to be successful with Medicare
billing, coverage and documentation requirements. This workshop will
provide insight for home health agency staff at all levels. Palmetto GBA
will provide information related to the most common errors identified
through a variety of data analysis and some hints and tips on the
reasons why these errors occur. Palmetto GBA’s ultimate goal is to have
educated and astute providers who know how to accurately and skillfully
apply the information they learn to their documentation and billing
practices! Speakers: Palmetto GBA Staff (4.00 clock hours Administrator/alternate; 4.00 contact hours continuing education for nurses)
Home Health Topics:
• Statistics
Length of Stay (LOS)
Disbursement
• Review Findings – Palmetto GBA and CERT Reviews
• Improving Your Practice
Health Information Supply Chain (HISC)
• Home Health (HH) Plans of Care (POCs)
Diabetes and the Home Health (HH) Benefit
• Medicare Program Changes for 2015
Reporting Principal Diagnosis Code(s)
- Etiology vs. Manifestation codes
• Data Analysis
Appeals
Provider Contact Center (PCC)
Claims
• Tying It All Together
Define, Measure, Analyze, Improve, and Control
(DMAIC) Process
• Provider Resources
Note: CMS requires that Medicare contractors track all educational
activities, which consists of capturing the provider’s six-digit
Provider Transaction Access Number (PTAN) and National Provider
Identifier (NPI). Attendees are asked to be prepared to provide this
information when they attend the workshop.
1:30 - 3:00 pm: Keynote
The Transformational Journey: Guideposts for Our Future - Presented by Mary Ann Christopher
The Opening Keynote will create the inspirational vision for the home
and community based industry at this time of transformation within
health care. The fundamental premise will suggest a future system in
which the cross continuum sector from payor to grassroots provider is
virtually aligned around a common commitment to patient centered,
community centric care. A call to action will be sounded to providers in
the home and community based space to embrace the principles of
population health, cross continuum partnership, disruptive innovation,
consumer engagement, evidence based practice, workforce development and
interprofessional teams. A roadmap for our imagined future destination
will be traversed in this 60 minute provocative opening session. (1.00
clock hours Administrator/alternate; 1.00 contact hours continuing
education for nurses)
3:15 - 4:30 pm: General Session
Branding for Success in Healthcare Transformation
Transforming your organization is critical in this post Affordable Care
Act environment. Value Based Purchasing, Bundling, and Accountable Care
Organizations will seek out and vet providers that use metrics to drive
evidence based practice. But unless you brand your organization well
your potential partners may just see you as one more home health agency
to weed out. Attendees will hear the latest on market analytics,
information on population health and home health quality indices.
Speaker: Nils Bunde, Brainforest (1.25 clock hours Administrator/alternate; 1.25 contact hours continuing education for nurses)
Wednesday, June 3
8:30 - 9:30am: General Session
Diversifying Revenue Sources for Increased Stability
This program will provide insight to strategies associated with
diversifying an organization's revenue models. There are many things to
consider as you evaluate alternative programs - from understanding your
demographics to the financial feasibility of a particular revenue
diversification. There is one thing for sure: there is no cookie cutter
approach to the right revenue diversification strategy. The program
will help participants recognize the importance of revenue
diversification in home care and hospice. Participants will better
understand methods for evaluating opportunities for revenue
diversification, and identify steps needed to plan and implement a
diversification into new lines of home care business. Speaker: Mark Sharp, CPA, BKD (1.00 clock hour Administrator/alternate; 1.00 contact hour continuing education for nurses)
9:45 - 11:00am: Concurrent Sessions
1a. Medicare’s Bundling Initiative: A Window into Value-Based Transformation
Medicare’s bundled payments initiative is a window into the new reality
of transforming payments from rewarding volume to value. Bundling
creates powerful incentives to change referral patterns and reshape care
delivery with an episodic mindset. Home health providers can play an
important role in this initiative and those that fail to grasp the
nature and speed of this transformation may be left on the outside
looking in as networks are narrowed and expectations about improved
outcomes at lower cost rapidly evolve. This session will cover: bundling
basics and timeline, differing roles for post-acute providers under
bundled payments, importance of care redesign and effective partnership
strategies, including gainsharing. Participants will come away from this
session with the understanding and motivation to prepare your
organization as bundling grows rapidly in 2015. Speaker: Brian Ellsworth, MA, Health Dimensions Group (1.25 clock hours Administrator/alternate; 1.25 contact hours continuing education for nurses)
1b. Innovations Across the Continuum, Lessons Learned Through The Illinois Homecare & Hospice Council MOOC
This session will describe how palliative care can be utilized across
the continuum to provide innovative care to patients who face serious or
chronic illness. IHHC along with key partners developed a Massive Open
Online Course (MOOC) to educate viewers on the concept of palliative
care and approaches to manage targeted patient populations. The One
Patient One Team MOOC explores how palliative care can improve
integration while positively impacting symptom management, readmissions,
and disparities of care. Learn how palliative care concepts can lead a
major paradigm for care coordination in your organization and impact
the quality of life for your patients and their families. Speaker: Cheryl Meyer, MS, RN, PHCNS-BC,
President, Illinois Homecare & Hospice Council, Director of
Clinical Excellence, Advocate at Home (1.25 clock hours
Administrator/alternate; 1.25 contact hours continuing education for
nurses; 1.25 SWCEUs)
1c. ICD-10- Are You Ready for the Transition?
Health care providers across the United States will transition to the
ICD-10 CM coding system on Oct. 1, 2015. Progressive home health and
hospice providers have been preparing for over a year. The effort
necessary to complete this major undertaking is not for the faint of
heart. Join Jennifer Warfield as she provides helpful tips in protecting
your agency from the surge of ICD-10. Learn how to properly prepare
your agency for a successful ICD-10 implementation and ultimately avoid
hazardous coding conditions. Speaker: Jennifer Warfield, RN, BSN, HCS-D, COS-C, PPS Plus Software (1.25 clock hours Administrator/alternate; 1.25 contact hours continuing education for nurses)
1d. Customer Service Strategies that Keep Clients Coming Back
Dazzle your clients and their families with better customer care, and
you will be astonished how fast your agency attracts new business and
keeps loyal customers coming back for more. Attend this session to get
tips for improving client care by keeping wait times down, being more
responsive, ironing out scheduling kinks and rewarding loyalty. Plus
find out how to create a more enjoyable experience on your website that
will make a memorable first impression. Speaker: Bob Roth, OneOnOne (1.25 clock hours Administrator/alternate; 1.25 contact hours continuing education for nurses)
1:00 - 2:30pm: Concurrent Sessions
2a. Hospice and Homecare Practices That Will Get You Investigated: Hot Button Issues for the Department of Justice
Health care fraud continues to be a top priority for the Department of
Justice. Nationwide there are nine Medicare Fraud Strike Forces using
data analysis techniques to uncover fraud. This program will discuss the
types of activities by home health and hospice providers that the DOJ
is focusing upon and will provide steps a provider can take to reduce
the risk that it will become a target. Finally, it will discuss steps
that a provider can take in the event it finds that it is the target of a
DOJ investigation. Speakers: Denise Leard, JD, Brad Howard, JD,
Brown & Fortunato (1.50 clock hours Administrator/alternate; 1.50
contact hours continuing education for nurses; 1.50 SWCEUs)
2b. Perfecting Performance Improvement
CMS is actively transforming from a passive player to an active
purchaser of home health care. Unfortunately, agencies often use length
of stay or discharge dates to measure outcomes. As a result, CMS is
putting forth efforts to pay for high quality, cost-effective care.
Agencies must be able to monitor and decipher the information from their
outcome reports in order to stay competitive. Additionally, Jennifer
will discuss the publication of the new star ratings, which are set to
post on the Home Health Compare website as early as July. Join Jennifer Warfield,
PPS Plus Software’s Education Director, for an informative presentation
describing ways your agency can improve its overall performance. (1.50
clock hours Administrator/alternate; 1.50 contact hours continuing
education for nurses)
2c. Compensation Models in Home Health
This session describes the most commonly used compensation models in
home health and the inherent incentives and unintended consequences of
each. Wage and hour risks are reviewed for each model as well as
strategies for minimizing risks. Providers will explore their own
compensation model and the barriers to desired outcomes. There will be
discussion that will help providers to decide the model that best aligns
staff and agency incentives. Speaker: Karen Vance, OTR, Baird Kurtz and Dobson (1.50 clock hours Administrator/alternate; 1.50 contact hours continuing education for nurses)
2d. Master Marketing Plans That Attract New Clients
This presentation will help agencies develop a marketing plan that fits
their business and assists them in understanding the ins-and-outs of how
to market, who to market to and when to market in the private duty
and/or home health industries. With Bob’s step-by-step marketing
process, attendees will learn the best methods for developing a
marketing plan that fits their unique business needs and for setting up
and delivering the most effective marketing budget for their company.
Bob will review the methods of “fishing in a barrel” vs. “fishing in the
ocean” when pursuing marketing opportunities. Through specific tools
directed at target audiences, individuals will see the marketing success
of Cypress HomeCare Solutions, ranked the #1 home care agency in
Arizona. Speaker: Bob Roth, OneOnOne (1.50 clock hours Administrator/alternate; 1.50 contact hours continuing education for nurses)
2:45 - 4:00pm: Concurrent Sessions
3a. Preparing For the External Contractor Review – Redux! Better Today Than Yesterday? Will You Survive Tomorrow?
Medical review of documentation is getting much more sophisticated!
Documentation is the government’s favorite way to stop payments. More
than five audit entities work diligently to get results, leaving
providers exhausted, worried, and financially drained. Just as agencies
felt they had made progress on documentation and appeal processes, CMS
and Congress are raving over stories of billions of dollars recovered by
CERTs, MACs, ZPICs, SMRCs, and RACs. The “more is better” philosophy
continues to drive the audit process. The evidence also shows that CMS
and contractors will fight overturning of denials all the way to ALJ
hearings when these begin again. “Position Papers,” successfully
introduced by one of the ZPICs at the ALJ, are now part of the arsenal
that other Contractors may use at future hearings. CMS is now training
auditors how to defend at the ALJ process! This presentation is aimed
at forward thinking home health administrators, directors, therapists,
and clinicians who will handle home health documentation reviews in the
future. The CMS improper payment philosophy will be covered as well as
how CMS is using contractors to design new ways to meet the objectives.
CERT, RAC, and MAC findings will be reviewed. Attendees will learn of
the auditors’ changes in focus over the past two years, specific areas
of denial, and tips and tools to educate and track performance in high
risk areas. Finally, attendees will receive a step-by-step appeal
process that starts the battle before a denial can be assessed. The
session is jam packed with news, views, and strategies to help defend
good care so you can keep payment for the care you delivered!! Speaker: Jan Spears, MJS & Associates (1.25 clock hours Administrator/alternate; 1.25 contact hours continuing education for nurses)
3b. Bridging the Multi Provider Communication Gap Via Technology & A True EHR
Communication among providers about a patient can be difficult without a
central repository for patient data. Lack of information can lead to
errors or omissions in treatment, resulting in readmissions to the
hospital or long-term care facility as well as additional costs to the
current and future payment models. This program will give you insights
on past and current federal legislation developed to foster the
communication among providers regardless of their individual preference
for an EMR system, how most state Health Information Exchanges are
organized and funded, as well as resources available to effective take
advantage of this technology today. Also, how is this information
protected from privacy invasion and what steps do individual providers
and states take to insure protection of data. Speaker: Mike Deck,
HealthCare Synergy, Inc. (1.25 clock hours Administrator/alternate;
1.25 contact hours continuing education for nurses; 1.25 SWCEUs)
3c. M&A Update for Home and Hospice Care Agencies
The home health and hospice markets have provided an interesting history
in mergers and acquisitions over the past two decades. Attendees will
learn about that history and get the latest information about today’s
M&A environment for home health and hospice. Speakers will analyze
two significant healthcare acquisitions currently in progress while
explaining the valuation process for home health. This session will
cover the impact of Medicare changes, reimbursement, audits, fraud and
abuse, managed care, Face to Face, and ACOs. Participants will hear an
analysis of the Gentiva acquisition by Kindred, Encompass by Health
South, analysis of performance for Almost Family, and discussion of key
factors affecting the market today. Speakers: Don Cummins, Founder, Joe Lynch, Partner, Stoneridge Partners (1.25 clock hours Administrator/alternate; 1.25 contact hours continuing education for nurses)
3d. Star Rating System- What Does This Mean for Home Health?
CMS and the Medicare program will soon begin rating Medicare home health
agencies using a "star rating" system. CMS has rated Medicare Advantage
plans using a similar system for many years. This session will review
basics of the new system, compare and contrast features of the Medicare
plan and home health rating systems, and note similarities between the
two systems and issues Medicare plans have raised with certain aspects
of the star ratings methodology. Speaker: Rhys Jone, MPH, Amerigroup (1.25 clock hours Administrator/alternate; 1.25 contact hours continuing education for nurses)
Thursday, June 4
8:30 - 10:00am: General Session
Healthcare’s Future - Not Just Closer to Home – But Care at Home
“To deliver transformational healthcare, we need to move beyond the
current model of traditional settings, and acknowledge that for many
sick, mainly older people, the home is where they need to be treated and
where they feel safe.” A KPMG executive expressed the organization’s
view of care at home at a recent international event. Legacy health
systems recognize that the traditional acute care model is fading, they
must make the leap to care at home and in the community. Maureen
Spivack, Managing Director and co-Head of the Healthcare Group at KPMG
Corporate Finance LLC, draws on over 20 years of healthcare investment
banking experience with providers and payers to discuss the current
transformation of our nation’s healthcare system. The industry is
experiencing an unprecedented level of convergence. Healthcare systems
have been forced to seek out new approaches to better define their value
and deliver care in the most cost effective manner. Ms. Spivack will
focus her remarks on how convergence along the care continuum is
impacting and creating opportunities for care at home and in the
community. Speaker: Maureen Spivack, KPMG Corporate Finance LLC (1.50 clock hours Administrator/alternate; 1.50 contact hours continuing education for nurses)
10:15 - 11:45am: Closing General Session
Washington, DC Update- What’s Changing and How Fast?
Healthcare is evolving rapidly. Population health, chronic disease
management, value based purchasing, and care transitions are no longer
just buzzwords for researchers, academicians, and policy-wonks. CMS is
driving healthcare transformation with new payment models, incentives,
penalties, and massive benefits integrity oversight. Tracey Moorhead,
President and CEO of the Visiting Nurse Association of America, has been
engaged in Medicare policy for almost 15 years, with 10 years in the
post-acute sector. Ms. Moorhead will enlighten attendees on the latest
in Washington, D.C. The rural add on, the Strategic Growth Rate (SGR) or
Doc Fix and how it impacts home care and hospice. She will share the
latest on the Affordable Care Act and what the next five years holds for
provides of care at home. Tracey has spent most of her career on
Capitol Hill, advocating for the aged and care at home. Speaker: Tracey Moorhead,
President, CEO, Visiting Nurse Associations of America (1.50 clock
hours Administrator/alternate; 1.50 contact hours continuing education
for nurses)
General Session - Hangin’ Tough - Gaining a Seat at the Health Care Table
Barbara McCann, Chief Industry Officer at Interim Healthcare, sees the
big picture for healthcare and homecare. Barbara will help attendees
gain a better understanding of home care’s place within a changing
healthcare environment. In this session you will discover opportunities
that ensure home care’s seat at the table as a vital player, and an
effective voice. Prior to joining Interim Barbara was executive director
of accreditation, plan performance, and clinical management alliances
at the Blue Cross Blue Shield Association. She designed and implemented
the association’s first national medical management alliance with the
American Geriatrics Society, and created the Blue Cross Blue Shield
national performance database, including HEDIS, and the first HMO report
cards for national accounts. She has also held positions with Caremark
and was director of home health and hospice accreditation at Joint
Commission. Speaker: Barbara McCann, Interim HealthCare (1.0 clock hour Administrator/alternate; 1.0 contact hour continuing education for nurses)
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