Overall Summary

· Increases the Medicare payments by 1.3% or about $250 million dollars

· Leaves most of PDGM intact

· Implement a new home infusion benefit

· Eliminate pre-payments (RAP)

· Make VBP performance data public

Financial Impact

Most important to many agencies is how their payments will be affected. CMS states that the projected 1.3% increase is based on how revenue is likely to be affected by propose policy changes, including PDGM. Below is a copy of table 36 from the proposed rule that shows how much each different agency type and location is expected to be affected.

There are also other factors to consider on the financial impacts for Home Health agencies in 2020.

HHVBP Model 

Under the HHVBP model there will be adjustments based on your performance data. The highest performing agencies will receive and increase in reimbursement and the lowest performing agencies will see a decrease. 

HH QRP 

Agencies that meet their reporting requirements are entitled to the full home health market basket percentage increase. Agencies that fail to meet their reporting requirements will be subject to 2% reduction in the market basket increase. CMS also concludes that the change in OASIS item collection as a result of the proposed changes to HH QRP effective on January 1, 2021 will result in a net additional annualized cost of $169.9 million dollars due to the increased cost of information collection.

Rural Add-On

Low Utilization Payment Adjustments 

Under the PDGM, LUPA Thresholds are calculated differently because they are now based on the unit of payment 30 days vs the current 60-day episodes. Under PPS the threshold was 4 visits. Under the PDGM LUPA Thresholds are determined for each payment group and vary from 2 to 6 visits. This means now instead of having a threshold of 4 visits for 60 days, you could trigger a LUPA as many as 12 visits over that same 60 days.

Elimination of RAP 

The proposed phase out and eventual elimination of the prepayments should not change the payment amount but it will affect an agencies cash flow because the amount you get up front will be less and eventually none under the current proposal. Agencies will eventually have to wait until the end of the 30-day payment period to submit the claim and get paid.

HealthWare is ready for PDGM. If your agency needs help preparing, contact us at sales@healthware.com to learn more on how we can assist. 

Microsoft has announced that they will end support for SQL Server 2008 and R2 after today. This means no more updates, including security updates. If you are a homecare agency, this means it is critical that you migrate now to a newer version or to the cloud because your system is no longer HIPAA compliant and could put you at risk for data breaches.

While you can upgrade to a newer version of SQL Server, the expense, energy and effort to do that can be far more than you were expecting. For this reason, many healthcare agencies are migrating their databases to the cloud. It’s not only a less expensive and less daunting option, but it helps to ensure your agency’s data is protected. Most clouds like Microsoft Azure are HIPAA and HITRUST certified. HITRUST is one of the highest security certifications and ensures that your agency’s data is compliant with HIPAA regulations.

Securing your data is more important than ever and should be part of any disaster recovery plan. We here at HealthWare can help make sure your data is secure and protect you from potential threats. Contact today at sales@healthware.com.

HealthWare is excited to announce our newest drug integration with PEPID, whose knowledgeable and expansive drug database is going to help our homecare agencies save loads of time! This integration is built right into HealthWare and is available in the back office as well as at the point of care. Gone are the days of nurses having to go outside of the software application to report on drug interactions, and no more double keying all the patient’s medications just to get these details. Entered once into HealthWare, a simple click of a button right on the medications form returns within seconds the report and details they need.

Now many of you might be saying this isn’t anything new, which is correct. Most EHR solutions provide a drug interface. Even HealthWare has worked with other drug interfaces, but we’re excited about the partnership with PEPID because they have made their product available to our clients at a very reasonable price. Most drug databanks available for interfaces are very costly, and with homecare agencies facing PDGM, they need to be able to save wherever they can, time and money! Our client’s success is important to us, and it’s nice to partner with another company who wants to help us contribute to their success. HealthWare’s CEO Jim Voytek adds “This is one of the best partnerships we have had with any vendor. Their willingness to work with us on the interface and to provide our customers pricing that fits our model and the market was very refreshing. We look forward to a long and mutually beneficial relationship with PEPID.”

About PEPID

For 25 years, PEPID has been a leading global developer of clinical and drug information resources and mobile applications for healthcare providers and institutions. Their trusted, validated content and intuitive workflow provide clinicians peer-reviewed support for diagnosis and treatment at the patient-point-of-care. It’s accessed individually or integrated into any healthcare system.

For more information about PEPID’s products and services, please visit www.pepid.com and request a demo, or contact sales@pepid.com.

About HealthWare

HealthWare Corporation has been providing information solutions since 1986, releasing our first Windows based product in 1992. What makes HealthWare unique is that we provide a single vendor solution to home care and hospice agencies that covers most aspects of operating an agency’s business, from financial to clinical to point of care. Because our system provides all the functionality of a Windows and web-based environment, we have been able to concentrate on making a system that not only has all these features but one that is also specifically designed to streamline your processes. For more information, please visit www.healthware.com and or contact us today for a demo.

Last month we reported on the importance of updating off of Windows 7, as Microsoft will no longer be supporting this version come end of year. This month Microsoft warns about a vulnerability that is effecting the older versions of Windows, to include not just 7, but also Windows 2003, XP, SQL Server 2008 and SQL Server 2008 R2.

Microsoft states this is a “wormable” bug, what that means is that it is capable of exploiting your network. These types of bugs are considered serious vulnerabilities and it has the ability to spread rapidly. Being wormable, it is likely to influence more than one device on your network if one gets hit and can even be contracted at the point of care, thus transmitting back and infecting your internal network.

It is also startling to read in Microsoft’s announcement that this is happening without any user interaction, thus adding to the criticalness that your systems have all the latest updates, but urging more than ever that you proceed with upgrading to either Windows 8 or 10.

As always, if you are needing assistance with upgrading, contact HealthWare at 850-479-9035 or at sales@healthware.com. We are happy to help keep your systems secure and do what we can to protect your patient data.