Hello and welcome to 2015. We are very concerned with the increasing government rules, regulations, claim denials and payment cuts. Did you know that your actual average home health episode reimbursement is less than it was when PPS began? During the same period of time inflation rose by over 30 percent. Medicare has placed increased pressure physicians to make it more difficult to refer patients to home health. First with the physician narrative, which thankfully has been eliminated as of January 1, but requiring their medical records to support the need for home health referrals. Remember physicians have always been required to document that patients are home bound and needed skilled care, now they are just increasing physician paperwork. Do you think that makes physicians more or less likely to refer patients to home health? I would guess it makes them less likely to refer patients. The impact of the above appears to show CMS is trying to close thousands of home health agencies.
CMS is making similar efforts in the hospice area, such as increasing government rules, regulations, and claim denials. Studies have proven that hospice saves the Medicare program compared to traditional care at end of life, but all CMS wants to do is to restrict hospice access. Medicare is concerned with hospice patients with length of stay beyond 180 days. Just because a patient lives beyond 180 days after they were admitted does not mean they were inappropriate for hospice at the time they were admitted. I do not believe any doctor in this world can determine the actual time and date of when a patient will pass away. I think they would admit that is beyond their pay grade, but still CMS still is trying to hold hospices to that unreal standard. I am not saying there has not been abuse in long term stays for hospice, but CMS's treatment of every hospice as guilty until proven innocent is not the answer. Establishing contractors such as RACs and ZPICs as bounty hunters is not appropriate since they are paid based on what they deny. The impact of the above appears to show that CMS is trying to close hundreds of hospices.
The federal government always advertises to our senior citizens that Medicare will cover their most of their health care needs. What they do not tell seniors is they are working diligently to reduce access to home health, hospices, physicians and other Medicare providers. They have several methods to reduce access by reducing payments for services, denying claims, adding new rules and regulations. We should continue to be advocates for our senior citizens to ensure they receive the Medicare services they deserve.
Even private duty home health agencies are not immune to the increase government rules and regulations. The government is not concerned about the care available to the patients in their home or the patient's ability to pay privately for care, or even the increased cost of their government regulations on Medicaid Waiver programs. The impact of the proposed changes to the companionship exemption and overtime rules shows their lack of concern.
Only the strong and well informed home health agencies, hospices, and private duty agencies will survive in the future. To keep our clients and friends informed and up to date we provide free email newsletters, we produce webinars, and we hold three day comprehensive seminars.
Our company mission is to help our clients survive and flourish. Why not join us in Las Vegas in January or February for one of our three day seminars and learn to survive and flourish.
http://dixonhealthcaresolutions.com/las-vegas-seminars/
