Kenyon Connects

For those of you who have been in home health for decades, the idea of competition between agencies revolved around how to get market share. You did marketing, developed relationships, maintained visibility in your communities and gave good care. With the nationwide expansion of Value Based Purchasing, competition has a whole new meaning to our industry. Let's look into the expansion. CMS began the original VBP project in 9 states on January 1st, 2016. It had 3 basic reasons listed for the project: Provide incentives for better quality care with greater efficiency; Study new potential quality and efficiency measures for appropriateness in the home health setting; and Enhance the current public reporting process. The goal was to show that quality scores could improve while there was a potential for significant savings to the Medicare program in dollars. The program showed that VBP did just that. CMS reports savings of $141 million annually with improvement of quality scores by 4.6% in those states originally involved. By this, it should be no surprise to our industry that CMS announced a nationwide expansion. CMS started the pre-implementation this year and has offered education to agencies to prepare for the full implementation on January 1, 2023. Agencies will see that payment rates will change beginning in 2025 based upon the performance numbers in 2023. You can register for the next scheduled CMS training entitled Navigating Performance Feedback Reports: Interim Performance Report (IPR) and Annual Performance Report (APR) which is scheduled for August 25th at 2pm ET. CMS also has many of the pervious recordings of trainings available for you here , so you can utilize the education and sign up for the listserv associated with Home Health Value Based Purchasing. The expanded Home Health Value Based Purchasing Model is set to base reimbursement on your performance in relation to other agencies like yours. It will look at certain quality measures each calendar year. Your OASIS, HHCAHPS surveys, and designated claims measures will calculate performance. An agency can expect between a -5% to 5% change in Medicare fee for service payments. So, what all this means for your agency is that you are not just competing for market share but for maximum reimbursement too. Agencies that do not perform will be hit for another loss to overall dollars. This could mean a transition of agencies no longer looking to provide Medicare services. It will be anticipated that certain agencies will not do well in the HHVBP model and not survive. The good news is that agencies focused on quality measures and patient satisfaction will thrive in HHVBP. Agencies need to keep the focus on Oasis accuracy, acute care hospitalization, and ER visits without hospitalization. Should you need consulting for your agency, Kenyon Homecare Consulting has senior level consultants with comprehensive knowledge and experience within the industry to help you navigate your clinical, operational, and financial needs. Call us today at 206-721-5091 or contact us online to see how we can help you succeed!

While working with agencies throughout the United States, we have the opportunity to see how many operate. This leads us to talk today about the new Oasis E tool being implemented January 1st 2023. For those who have been in the industry for decades, the implementation of a changed tool is not unusual. In our experience, when agencies educate on Oasis changes, it is normally limited to clinical staff who complete the tool. We need to look at this from the standpoint of ICD 10 coders. It is imperative for your ICD 10 coders to know the assessment tool inside and out. What Are The Changes From Oasis D to Oasis E? CMS updated the Oasis E tool on May 16th, 2022 and provided a PDF to the changes from the February 1, 2022 version. The changes are in line with expansion of Home Health Value Based Purchasing (HHVBP). So, it aligns with outcome based reimbursement. Now more than ever, the Oasis must be marked properly. We see the implementation of 3 different assessments within the tool: Brief Interview for Mental Status (BIMS),Signs and Symptoms of Delirium from the Cognitive Assessment Method (CAM), and the Patient Mood Interview (PHQ 9) which allows for expanded screening for depression. McBee and Associates offers a nice visual crosswalk tool to illustrate the changes from the Oasis D to E. What Does This Do For ICD 10 Coding? It means your Oasis needs to paint the actual clinical picture. Your ICD 10 coding isn't accurate if the documentation doesn't align. This isn't new. Now, HHVBP is going to need to see the outcomes on our patients come to fruition or your reimbursement will suffer. The check and balance of the certified coder means they need to understand the assessment tool as well or better than the nurse who does the assessment. The nurses look at the tool in a different way than the certified ICD 10/ Oasis coder. This is the analogy of the 2 sides of the brain. Putting both of these clinical pieces together is the whole picture and therefore, the whole brain completes the Oasis and coding puzzle. The coder is able to catch discrepancies or address items that don't fully align with the diagnoses based upon other documentation. You may currently have your agency doing coding in-house and if your coders are Oasis and ICD 10 certified, then great. Check their ongoing accuracy and whether it makes financial sense to keep it in-house. Spend the time and money to make sure your ICD 10 coders keep up-to-date on changes. If you don't have certified coders in place, then outsource your coding and Oasis review or you may really be penalized for errors in the tool. If you are looking to outsource, then make sure the person doing the coding is certified in ICD 10 and Oasis. Agencies Can't afford to have Oasis or ICD 10 coding errors cost them money. If you are looking to check the accuracy of your current coding system, outsource your coding, or need someone to provide educational assistance on the new Oasis E tool, Kenyon Homecare Consulting can help. Call us today at 206-721-5091 or contact us online to see how we can help!

Running an organization can be a lot like playing the game of football. You compete, you train, you break a sweat. Sometimes you score amazing touchdowns, and sometimes you miss easy field goals. Chronic disease education is that extra push you need to win the game of homecare. It gives you lightning feet to outrun your competitors and a strong defense to protect your best players which, in homecare, are your clients. Let’s look at three game-changing benefits of chronic disease education. Chronic Disease Education Prevents Penalties In football, a penalty can cost you the game. And the cause behind most penalties – simple mistakes! A player on the line moves too soon, interferes with a pass or gets caught stepping out of bounds. There are a million easy-to-make errors in football that can cost a team valuable yardage. The same is true of the homecare industry. When your caregivers aren’t adequately educated, numerous mistakes can be made. Only, those affected are your frail clients, not some tough football players. And the results are far more detrimental than a lost game. Client hospitalizations, legal repercussions, fines and lost revenue occur as a consequence of poorly educated homecare aides. With advanced aide education, you can rest assured that the majority of these penalties won’t happen. Your caregivers will have the knowledge to handle even the most difficult situations. Chronic Disease Education Scores New Clients There are several ways to score in the game of football, from the obvious touchdown to the not-so-obvious safety. And don’t forget about field goals. Coaches spend significant time and effort strategizing with their teams about the best way to score the most goals in each game. Doesn’t it make sense to do the same with your homecare agency? Chronic disease education meets goals and scores new clients for your organization with client satisfaction and professional referrals. Client Satisfaction – Even in today’s digital age, word of mouth continues to be the best method of advertisement. Chronic disease education gives your caregivers the knowledge and experience they need to provide superior care, which improves client satisfaction. And who better to spread the word about your agency than happy clients? Professional Referrals – In homecare, it’s important to foster mutually beneficial relationships with other medical professionals in your community. When these referral sources know you make the extra effort to provide advanced education, they become more trusting in your ability to deliver specialty care required by their patients. Scoring is just as crucial in homecare as it is in football. With advanced education for aides, your chances of scoring big increase significantly. Chronic Disease Education Creates a Competitive Edge To be as competitive as possible, football teams watch replays of their opponents’ games. They study the other team’s strategy, best players, and weaknesses. By taking the time to educate themselves on these vital aspects, they develop a deeper competitive edge. When game time comes, they’re ready. The same can be said for chronic disease education. Studying worsening symptoms, treatment methods and potential warning signs for specific diseases gives your caregivers a knowledge that others in the field don’t have. What does this mean for your agency? You can advertise and offer specialized services, thus outplaying your competition. Why Choose Kenyon HomeCare Consulting’s Aide University As the only online continuing education program of its kind, Aide University teaches specific chronic disease care enabling organizational success. Aides gain the knowledge to become competent and provide quality care while furthering their careers and outshining their competition. Courses provided at Aide University include the following topics: Recognizing red flags Decreasing hospitalizations Lowering healthcare costs for clients Proactively intervening on a client’s behalf When you’re ready for a game-changer that will take your organization to the next level, consider the benefits of chronic disease education provided through Aide University. Contact us to learn more!

Clinical employee retention is such a loaded subject. There are so many facets to what makes a clinical employee stay or leave an agency. You have to consider everything important to the employee while realizing generational issues greatly changes the focus for each individual. So, in considering wage, benefits, vacation, family leave, onboarding and the generation of employee involved, have you thought about what robust educational programming brings to the table? Have you ever considered it as a retention measure?

Chronic disease management is something that is so vital to patient outcomes and efficient patient care, but it is often put on the back burner of day-to-day operations. So ask yourself why you haven’t invested in keeping chronic disease education on the forefront of your plan. Is it financial? Is it because you don’t have the staff to pull from the field? If it hasn’t been something you have thought about in a long time, then it’s time to revisit your plan.

Consider online options to help you complete you home health aide training more efficiently while costing you less at the same time.