Delta Connect Blog

Letters Proposing Phased-in Approach for Home Health Care Face-to-Face

Posted by Crystal Parks on Dec 17, 2014 11:55:32 AM

Last week, NAHC President Val J. Halamandaris sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner. This letter urged a phased-in approach to the new home health care face-to-face documentation requirements scheduled to take effect on January 1, 2015.

The letter highlights CMS’ past willingness to phase-in new requirements for home care providers, as well as reiterating the challenges that both home health agencies and physicians will face if the new requirements are not phased-in. 

NAHC's affiliate, the Forum of State Associations, sent a letter to the CMS Administrator on December 12, 2014 also urging a phased-in approach to the new face-to-face documentation requirements. 

With the January 1, 2015 effective date fast-approaching, NAHC will provide updates on any developments on the face-to-face issue through future issues of NAHC Report.

Given the challenges the January 1 effective date will pose for the new face-to-face documentation requirements and other regulatory requirements in effect January 1, 2014, how beneficial would a phased-in approach be for your organization?

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Topics: Face to Face, Home Health

A Guide to Identifying a Short List of Home Care Software Vendors

Posted by Josh Keely on Dec 16, 2014 10:00:00 AM

When someone is looking for financing on a home purchase, it is common practice is to select three to four lenders, and get a quote on APR, fees, points, and closing costs. People choose to do this to help ensure the decision they’re making is a well-informed one. But how do they narrow down the list of lenders (literally in the thousands) to a manageable three or four? They might choose their own bank (deciding factor: trust), a lender who has a good reputation in the industry (deciding factor: knowledge), and a lender who advertises an attractive rate (deciding factor: intrigue).

As with financing a home, the dozens (and dozens) of vendors supplying homecare software can be overwhelming. You’ll likely want to narrow down the field before you invest time in performing due-diligence. Identifying a subset of vendors is usually the easy part, but can still be tricky (click here for what to do when you’ve narrowed them down). Below are a few tips to help you identify a select few to focus on.

Tips on “Narrowing the Field” when it comes to Home Care Software Providers

Stand on the shoulders of others

Sometimes, it makes sense to simply leverage the power of the informed consumer. There are a plethora of resources available to anyone with Internet access. Organizations such as KLAS frequently rate home health software providers based on independent, anonymous surveys of actual users. These surveys discuss multiple aspects of the software providers, including sales, training, functionality, and service. Select the top 3 to 5 vendors on this nationally ranked list, and begin your process. Request a free copy of the latest KLAS report.

Use an industry expert to help guide the process

While there are many resources available to make informed buying decisions, sometimes the process still warrants the services of an industry expert (e.g., a “consultant”). Finding an industry expert who will be best suited to perform this task is a job in and of itself, and also requires careful selection. Many consultants “recommend” vendors based on referral agreements, but there are also many good consulting groups who will charge you for their services, and help select a software package best suited for your agency.

Let them come to you

Using an RFP (Request for Proposal), you can solicit bids from vendors of your choosing. Depending on your internal level of expertise, this may require the assistance of an industry expert to help you create the RFP. Once created, you can “invite” vendors to bid, simply by contacting them and submitting the RFP. Keep in mind that the more you submit, the more responses you’ll need to weed through. Depending on the depth of your RFP, it may make sense to create a scoring mechanism to help weed out those who fall below a pre-determined threshold.

Remember that with any significant purchase, you should be willing to invest the time necessary to make the decision. Making a decision based on subjective data can get you into trouble. Don’t be afraid to ask tough questions—it’s your budget after all!

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Topics: Home Care Software

Survey Mode Experiment for Hospice CAHPS Survey Responses

Posted by Crystal Parks on Dec 12, 2014 9:30:00 AM

The National Association for Home Care and Hospice (NAHC) has learned that the Centers for Medicare & Medicaid Services (CMS) is launching a Hospice CAHPS Survey Mode Experiment. CMS is seeking information to help in the development of adjustors that will allow for better standardization across hospices that participate in the CAHPS survey. The experiment seeks to adjust accordingly to the survey mode used by the different hospices: mail, telephone, or mixed mode. CMS is working with the RAND Corporation on the project and outreach by both CMS and RAND is currently being made to selected hospices relative to participation.

Hospices should note that the hospice participants for this project have been selected by CMS based on them having met specific criteria that have been established. CMS is not taking additional hospices into the experiment at this time.

According to CMS, the mode experiment will help CMS develop survey mode adjustments to achieve the goal of fair and standardized comparisons across all hospices that participate in the CAHPS Hospice Survey. It is necessary to make adjustments to account for the effect of the mode of survey administration in which caregivers respond to the CAHPS Hospice Survey. These adjustments are intended to eliminate any advantage or disadvantage in CAHPS Hospice Survey scores that might result for a hospice based on the mode in which its caregivers respond to the CAHPS Hospice Survey.

CMS’ contractor, the RAND Corporation, will collect survey data for the mode experiment at no cost to the participating hospices or their survey vendors. The cost of conducting the mode experiment is funded by CMS. Participation in the CAHPS Hospice Survey mode experiment will fulfill hospices participation requirements for the CAHPS Hospice Survey administration during the mode experiment data collection period (April through September 2015). Although the RAND Corporation will act as the participating hospices’ survey vendor of record during this time, hospices are welcome to maintain their contracts with their vendors. 

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Topics: CMS, National Association for Home Care and Hospice, Hospice CAHPS

Five Questions to Ask When Selecting Home Care Software

Posted by Josh Keely on Dec 11, 2014 4:58:43 PM


Selecting new home health, hospice and private duty software can be both a daunting task and a significant investment in time. Choosing a homecare software package that is right for your agency requires focus, coordination, and diligence. Asking specific questions will help you make an informed decision, which will ultimately help to support your agency in this tumultuous sea of healthcare reform, regulatory changes, and competitiveness.

Be sure to ask, at minimum, these five questions to software providers. Ask open-ended questions, and seek out the answers in the narrative response. Anyone can answer “yes” to a question such as “Do you have phone support?”

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Five Questions:

Can you describe any installation or setup fees associated with your product?

Many software vendors supply attractive pricing on an OPEX (Operating Expense) spending model, but additional-costneglect to inform you of all the “nickel and dime” fees. These add up quickly, and can quickly sour a deal if exposed. Be certain to listen for any of the following, and detail the costs associated: implementation costs, training fees, expense policies, “turn up” fees, interface costs, software upgrade costs, maintenance, or licensing fees.

Can you explain your support model?

The quality of support for a given product can make or break a relationship. Listen for SLA (Service Level support-image-300x300Agreement) minimums, average time to resolution, time to response, etc. It’s also important to know if there are various levels of support, e.g., basic support is included, but if you want turnaround quicker than 24 hours, you must pay for another tier of support. If you want to put the service to the test, have them call the support line with you on the phone. See how quickly they answer (or if you go on hold for 15 minutes), and what is said when answered. This will give you an idea of what’s behind the company’s support offering.

Which devices are compatible with your software?

Be sure to inquire as to any proprietary hardware, OS (Operating System) requirements, minimum mobile-devices-1024x768processor type, memory, and screen size to help you budget for hardware to run the software. The difference in endpoints can range from $400 each, up to $3000, and can have a severe impact on your device budget. Also, for larger agencies, MDM (Mobile Device Management) solutions are important. When a security patch comes out for a piece of hardware, or a new software application needs to be loaded on 100, 500, or 1000 individual devices, this can put a strain on your IT operations. Be certain that the solution supports a MDM strategy to help with your bottom-line costs. If possible, get your hands on a demo unit and hand it to a clinician for a test run.

Can you supply documentation for uptime for the past 12 months?uptime

Anyone can talk about 99.99% uptime (or “four nines” as it’s known in the industry), but few can document it. Vendors who care about monitoring and keeping SLAs will be tracking and documenting it with a reputable tool/company. These tools can generate a certified report of outages and uptime, and is a good show of faith as a vendor selling a crucial line-of-business service.

Can I speak directly with your customers?

Not that anyone would want to call every single customer on the list, but the mere question should prompt phone_callsa response worth listening to. Let’s face it - vendors are going to offer up the customers who will provide a favorable review of the software. If you want to see how confident a vendor is in their ability to provide a quality service, ask them if you can speak with someone who went live on the software in the past 3 months. Typically this will give you a very clear and accurate picture of how the implementation, education, adoption, and follow up processes went. If they squirm, you might want to think twice about pursuing talks with the vendor.

 



Once you get past the selection process, you’ll need an internal “champion” who will help to partner with the software vendor’s implementation group to make the rollout successful. Industry-wide studies show that productivity rates will drop with the adoption of new software, regardless of how “shiny” the software is. Learning something new is always challenging, so be prepared for resistance, hurdles, and productivity hits - but don’t give up! Choosing the right vendor for your agency should be a decision that results in helping you to stay competitive, maintain compliance, and provide quality patient-centric care.

Stay tuned for a follow-up to this article, titled “Narrowing the Field (A Guide to Identifying a Short List of Home Care Software Vendors).” This will help you to narrow down the list of vendors from virtually dozens to a manageable few.



 

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Topics: Home Care Software

Legislation Introduced that would Affect Home Health Providers

Posted by Crystal Parks on Dec 5, 2014 2:36:16 PM

According to NAHC, House Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) and Ranking Member Jim McDermott (D-WA) introduced the Protecting the Integrity of Medicare Act (PIMA) (H.R. 5780) this week. Included in section 15 of the legislation is a provision that would impose a home health surety bond of not less than $50,000 that is “commensurate with the volume of payments to the home health agency.”

CMS has the authority under the ACA to impose such a surety bond, but has not chosen to do so. H.R. 5780 would make it mandatory. 

This legislation could come to the House floor next week under suspension of the rules requiring a two-thirds majority vote. If it passes the House, it would then go to the Senate. If taken up by the Senate, it would likely be under a procedure called unanimous consent because of the short time remaining in the lame duck session. This means one Senator can stop it from coming to a vote during the lame duck session.

Home care providers are urged to send a message to their Representatives and Senators asking them to oppose this legislation unless the home health surety bond provision is removed.

Some surety bonds talking points from NAHC to emphasize are:

  • it will hurt home health small businesses already struggling to comply with so many expensive and unreasonable regulatory burdens and thus threaten access to care;
  • it’s in effect a tax on the vast majority of ethical providers to cover the cost of a few bad actors;
  • it leaves wide discretion to CMS in setting the bond amount and implementing the requirement;
  • there are so many better ways to protect the integrity of the Medicare home health program;
  • any surety bond requirement should be time-limited and targeted to new providers only as rarely do longstanding providers present a risk to Medicare; and
  • this legislation should not be rushed through Congress during the lame duck session without committee hearings and markup.

Please take a moment to urge your Representative and Senators to oppose the Protecting the Integrity of Medicare Act (H.R. 5780) unless the home health surety bond provision is removed. For contact information, click here: Contact Your Elected Officials. When calling, ask the receptionist to connect you with the staffer who handles health care issues.

NAHC is exploring other options for grassroots action to communicate concerns about the home health surety bond proposal, such as social media and emails. However, because of the very short timeline, let’s get started with phone calls to the health staffers for your Representative and Senators.

NAHC will share further updates via future issues of NAHC Report.

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Topics: National Association for Home Care and Hospice, home care providers

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