Today’s post-acute care market requires comprehensive solutions for complex issues.
In the grip of a lingering COVID-19 public health emergency, organizations across the post-acute care spectrum were feeling the slow squeeze of falling profit margins and the pinch of nationwide worker shortages. Even now, agencies are struggling to develop recruiting and retention strategies to find and hold onto savvy leadership and top talent. SimiTree shores up the home health and hospice industry with talent solutions and knowledgeable interim management services.
Profitability in this market is tied to expertise and innovation. Agencies are scrambling to find innovative solutions, from leveraging technology to effectively using telehealth services that can’t yet be billed under Medicare. It’s a challenge to stay abreast of increasingly complex regulatory requirements for both home health and hospice billing and coding. More new processes are ahead, with 2022 ushering in a new Notice of Admission (NOA) for home health billing, and accelerating the need for clinical and coding expertise in order to see full reimbursement. For many agencies, outsourcing coding or the revenue cycle is the only viable solution.
Navigating PDGM: Key Strategies for Home Health Agencies
PDGM, Medicare’s complex new reimbursement methodology, has upended business as usual since its 2020 launch, replacing home health’s previous therapy-driven prospective payment system with a complex reimbursement framework dependent upon shorter billing timeframes, greater diagnoses specificity, and multiple patient-specific variables. Home health reimbursement is hostage to comprehension of the nuances of the complex payment model, and an agency’s success hinges on how well its coders and clinicians perform. PDGM continues to evolve with revisions of the case weight mix, new pairings of comorbidities, and other variables, increasing the need for coding and OASIS accuracy. Learn more about maximizing revenue and growth with SimiTree's PDGM Analysis.
Hospice Hurdles: Compliance and QAPI: Meeting Hospice Regulatory Requirements
Hospice has its own compliance hurdles. New policies are reshaping the field and holding agencies to greater levels of accountability. From new hospice survey requirements to a more stringent Hospice Quality Reporting Program with a Hospice Care Index, the regulatory and compliance scrutiny on hospice continues to intensify, and survey readiness development is crucial. Hospice agencies are also adjusting to a new initiative to assess the patient experience, including a new star rating program for the Hospice Consumer Assessment of Providers and Systems (CAHPS) program, a multi-year initiative of the Agency for Healthcare Research and Quality (AHRQ). Having in place an effective QAPI program can help boost star ratings, but many agencies struggle with implementation and the labor-intensive monitoring and updating required. SimiTree offers a fully outsourced QAPI program. What are the four elements of QAPI?
Performance Metrics: Using Data Analytics to Improve Post-Acute Care Performance
Tracking and understanding key performance metrics is crucial for the success of both home health and hospice agencies. Agencies are increasingly seeking data analytics services to measure their performance against state and national norms, monitor ongoing performance and make more effective, data-based decisions.
The Centers for Medicare and Medicaid Services (CMS) is taking home health performance metrics a step further, ramping up the importance by tying performance to payment. A nationwide expansion of a Value-Based Purchasing model will incentivize home health agency behavior with performance-based payment adjustments. Agencies will see payments adjusted in 2024 based on 2022 performance data.
The Makings of a Volatile Market: Maximizing Value: Expert Guidance on Mergers and Acquisitions
The challenges are taking their toll on the market, prompting a flurry of home health and hospice mergers and acquisitions, new strategic partnerships, and joint ventures. Stakeholders are pondering important questions: Should I buy? Sell? How much is my home health agency actually worth? How can I diversify to create new revenue streams? They need trusted guidance for a professional valuation, market assessment, targeted acquisition search, and more.
How SimiTree Can Help: A Full Spectrum of Support
SimiTree offers a full spectrum of clinical, financial, and operational support to help organizations answer these questions, meet their challenges, adapt to changes, and grow in today’s complex and confusing market.
In 2022, SimiTree acquired Florida-based Imark Billing allowing SimiTree to expand upon its billing, coding, and consulting services in post-acute care. The acquisition of Imark Billing is the ideal next step for SimiTree as it continues to expand the scope and scale of services and solutions, furthering the mission to help post-acute organizations become stronger and healthier overall by aligning business and care. This move delivers the scalability SimiTree needs to address the industry’s growing need for its services, no matter the size or census. SimiTree continues to help its clients address challenges, identify strategic growth opportunities, and improve profitability.
Together, we have the resources, expertise, and multi-faceted solutions to raise performance levels for our clients and position them to realize revenue potential. We’re committed to changing the post-acute industry by aligning business and care in a way that makes organizations stronger, healthier, and better able to focus on patient needs.