Strategies for Home Care and Hospice

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1 Strategies for Home Care and Hospice Helping Agencies Be Invincible to Our Industry s Unprecedented Regulatory and Payment Challenges. Guiding the Way to Quadruple Aim.

2 The Why of Fazzi... We exist to help home health and hospice agencies improve quality, profitability, efficiency, and patient and family satisfaction. Our mission is to make a real difference in healthcare by strengthening the quality, value and impact of home care, hospice and community based services. Our Value to You Workforce and Staffing Challenges OASIS-D Readiness Pre-Claim Review Patient Driven Groupings Model (PDGM) payment reform Hospice Public Reporting Hospice Evaluation and Assessment Reporting Tool (HEART) due diligence and organizational design for M&A strategies These are challenges, no question. But are they threats or opportunities? That will depend entirely on strategies chosen and how they are deployed in each agency. Fazzi has solutions to help the leaders of home health and hospice agencies manage and navigate these significant industry changes and challenges for the betterment of their organizations. Our Difference The Fazzi difference is driven by our people. We ve run agencies been in the field walked the revenue cycle and are dedicated to you and the patients and families you serve. Our team includes some of our industry s most respected leaders with extensive clinical, operational and financial home health and hospice expertise. With our broad range of capabilities, we re uniquely able to customize and integrate multiple services to help each customer reach their goals. Our approach is collaborative and consultative resulting in a valuable partnership tailored to your circumstances, challenges and objectives. Only Fazzi conducts national best practice studies and incorporates this research into everything we do. We know what works and what doesn t from our research and from the data and experience of working with thousands of agencies across the country for 40 years. fazzi.com

3 Outsourced Coding Are coding inaccuracies costing you money or putting you at risk? Are you deploying your resources strategically? With over 50% of codes impacting reimbursement, coding accuracy is critical to your bottom line. At the same time, you need to make sure that inaccurate coding does not lead to compliance issues that cost time and money. Agencies across the country are turning to Fazzi in big numbers in order to improve accuracy, reimbursement, quality, compliance, and to gain operational efficiencies. With Fazzi s coding, you benefit from the expertise and experience that comes with being one of our industry s oldest and largest coding companies. Specifically, you benefit from our: Certified coders who are tested prior to employment and continuously trained and subject to random audits. Consultative approach directed by our senior level clinical and operational experts. Two business day turnaround. HIPAA compliant, proprietary infrastructure that meets the most rigorous data security standards in the industry. Process tips and advice from experience with over 20 EMRs. Optional service levels to meet your needs. Differentiated process, working inside your EMR, for maximum efficiency. (Many customers who have switched from other vendors have told us our process is better.) According to the latest National State of the Industry Report, agencies have moved to outsourcing to reduce cost, increase sophistication for specific functions and avoid the growing challenges of turnover and staff shortages. Melanie Duerr, RN, MS, ANP, AHIMA ICD-10 Certified Trainer Chief Clinical Executive for Outsourced Services Kelly Murphy-Miller, AHIMA ICD-10 Certified Trainer Director of Coding Operations Kerry Termine, DPT, BCHH-C, COQS, AHIMA Approved ICD-10-CM/PCS Trainer Director of Coding Quality

4 Outsourced Billing Are you collecting every dollar you re due? In today s healthcare environment of shrinking reimbursements, governmental mandates, Medicare policy changes, and increased regulatory scrutiny, the importance of maintaining a healthy revenue cycle is second only to providing the best possible patient outcomes. Without an adequate margin there can be no sustainable mission. More and more agencies are choosing to outsource all or part of their revenue cycle management functions to reduce the cost of recruiting, training and managing staff and put these mission-critical back office functions in the hands of Fazzi s experts. Our outsourced billing, cash posting and claims management services include: Establishment of a claims submission schedule designed to maximize cash flow and avoid write offs. Billing and cash posting for all payers. Reconciliation as posting occurs and on a monthly basis. Follow-up collection actions from third-party payers on unpaid claims to optimize timing of collections. Monitoring for and notifying your personnel of claims selected for medical review or ADRs from payers, including tracking such claims until payer determination is issued and notifying your personnel of denied claims to be assessed for possible appeal. Monthly scheduled calls with your team to review performance, payer matters, current or pending billing related to regulatory and other similar matters; and to review billing, cash performance, and denied claims reports. Maintaining revenues and receivables reports and assisting in coordinating month end accounting period cutoff. Assistance in filing quarterly Medicare credit balance reports. Many of our clients have seen up to a 30% increase in denied claims collections since transitioning to our proprietary claims management platform. Diane Poole Director of Revenue Cycle Management fazzi.com

5 The Fazzi Learning Center How well trained is your workforce? A highly trained workforce is necessary for quality and productivity and it contributes to employee engagement and retention. Fazzi s suite of educational programming and services is our industry s best because: Our content is created specifically for home health and hospice by leading home health and hospice experts. We keep our content up to date with the latest regulations and best clinical and operational practices so you don t have to. For example, Fazzi Learning Center customers will automatically get our OASIS-D Readiness program with a cross walk training series, OASIS-D proficiency testing and updated content. The quality of our education programs is evidenced by our being the only firm in our industry to be accredited by the International Association for Continuing Education and Training (IACET), the premier standards-setting organization for adult learning and professional training. We are also proud to tell you that we are accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. Lindsay Doak, MBA Director of Education Our educational services include: The Fazzi Learning Center, our online university of clinical, operational and regulatory trainings and learning management system (LMS). From new hires to experienced leaders and your brightest stars, keep your workforce continuously trained with the best content in the industry and our cutting edge distance learning features of testing, tracking and reporting. The Fazzi Learning Center includes our acclaimed OASIS Package, the gold standard of OASIS competence. The Fazzi Learning Center content license. If you have your own LMS and don t need ours, you can still benefit from our outstanding training programs through a content license. We deliver our content to you and keep it up to date for you. Customized in person trainings at your locations. Ride along trainings in the home. SupervisionPlus certificate program. Certification: Certified OASIS Quality Specialist (COQS) Certified Home Health Case Manager (CHHCM) Certified Hospice Case Manager (CHCM) Board Certified Home Health Coding (BCHH-C) Anita Werner, RN, BCHH-C, COQS Senior Compliance Consultant Fazzi has the best OASIS trainings in the industry. No question. -Stacy Olinger

6 Operational Consulting Are you achieving your KPIs? Agencies of all sizes and types are asking Fazzi to take an outside in look at their organizations to help them navigate the unprecedented regulatory, payment and staffing challenges facing our industry in pursuit of quadruple aim outcomes. An Operational Review by our team of experts is a deep and systematic effort to identify processes, practices, staffing ratios, and structures that do not add value to your agency and could have a negative impact on quality and/or cost. We will walk the revenue cycle, observing operational work processes for consistency, organizational waste, and optimal integration of your software platform. We will examine your clinical modeling and your preparation for future models of care delivery. We will conduct a gap analysis, comparing you to national best practice and your specific agency cohort best practice. Our deliverable will be a set of clear and actionable recommended improvements encompassing structural, operational, financial, clinical and employee engagement practices. Cindy Campbell RN, BSN Director of Operational Consulting Our goal for all our clients is to achieve: The highest 20% for likelihood to recommend Greater than 90% skilled clinician retention Lowest 20% for hospitalizations Lowest 20% cost/episode fazzi.com

7 Compliance Services Would you give your compliance program an A? It s no secret that government scrutiny in home health and hospice is greater than ever. Regulatory requirements are constantly changing, putting pressure on agency leaders to maintain compliance while sustaining a commitment to providing high quality patient care. Fazzi will assess where you stand, tell you where you need to improve, and be there when you need us most with a wide variety of audit, review and regulatory consulting services. We offer: Clinical record audits to mitigate financial and compliance risk and to improve accuracy for better quality and financial outcomes. Compliance audits in real time to reduce your risk for ADRs and denials. Help with timely and accurate submission of the ADR and/or appeal documentation. We ll support you every step of the way at any level of appeal. Help when you need it most. Have an urgent need such as a complaint or the follow-up to a Medicare Survey? Our experts are here to help you with your documentation review, plan of correction, education and more. IRO services. Agencies entering into a Corporate Integrity Agreement (CIA) must retain an Independent Review Organization (IRO) to review documentation and claims. Fazzi s team of experts are available to serve as an IRO. Our expert reviewers will help you ensure your compliance using a collaborative and educational approach. Due diligence services. Agencies seeking opportunities to expand through merger or acquisition are wise to include a compliance program assessment and clinical record reviews in the due diligence process. More and more agencies and their M&A agents are turning to Fazzi s team of experts for these services. According to the latest National State of the Industry Report, reimbursement and Medicare changes and regulations are the top concerns of agencies across the country. Gina Mazza, BSN, RN, CPHQ Senior Vice President of Regulatory and Compliance

8 Survey Services Does your home health and/or hospice CAHPS vendor help you improve your scores? With real time reporting, special client trainings and consultant assistance, Fazzi s Home Health and Hospice CAHPS services are far more than just fast and accurate survey delivery and reporting. We are the only national benchmarking service that incorporates findings from primary research and consulting divisions in helping to guide agencies in best practice strategies for improving patient and family satisfaction. Agencies benefit from these valuable features of our services: Mail and mixed mode data collection options Customized survey and cover letter Dedicated team providing you exceptional service Above average response rates for all survey modes On-demand access to completed surveys Network and branch reporting Timely and accurate submission of your results to CMS Surveys in all CMS approved translations Adverse and Best Survey Reports On demand access to reports with national, state, and best practice benchmarking Best practice trainings and consulting All surveys report (One report, all surveys) Fazzi Top 25 Award of Distinction Fazzi s response rates have consistantly exceeded national averages reported by CMS. fazzi.com

9 Employee Engagement How engaged are your employees? A highly engaged workforce is important to building an efficient staffing model which starts with retaining your current and future star performers. Engaged employees have a real passion about their work and will always go the extra mile for you and their patients! The best way to improve engagement is to conduct an annual employee engagement survey. Fazzi has the only employee engagement survey service designed specifically for Home Health and Hospice. We ll work with you to customize the survey for your organization. You receive results by discipline, job level and by priority areas. You receive a comprehensive report with actionable recommendations to help decrease turnover and increase engagement, commitment and productivity. Our Employee Engagement service is built on the premise that data leads to improvement. Our recommendations are reality based from over 30 years of consulting in the home care and hospice field. Decrease turnover, improve productivity and boost your bottom line today! According to the Society for Human Resource Management, High levels of engagement promote retention of talent, foster customer loyalty and improve organizational performance and stakeholder value.

10 Interim Management Can you afford a gap in leadership? Don t let a gap in leadership put your agency at risk. Through our Interim Management services, your organization will benefit from a highly experienced and skilled executive who will work on a temporary basis with you while filling a void in leadership. Executives may work anywhere from three to twelve months, full time or part time, depending on your needs. Fazzi s Interim Management Provides: Rapid Results: Skilled executives who focus on positioning your agency for success in performance, efficiency and organizational effectiveness. Expertise: Your agency will benefit from our executives industry experience and capabilities. Smooth Transitions: Our executives will effectively take you through transitions and changes and give you the time you need to fill your position with the best possible candidate. Research shows that agencies are most vulnerable to competitive attacks after the departure of a leading figure; CEO, CFO, COO or clinical executive. Competitors may see this as an opportunity to take advantage of the unstable circumstances. Eileen Freitag, MBA Director of Strategic Consulting What can an Interim Leader from Fazzi do for your agency? Maryanna, our Interim Leader from Fazzi helped us tremendously. She was a star. Really, she was the linchpin that moved the organization forward while we searched for a new Director. We made a lot of changes during this time including changing pay practices and selecting an EMR vendor. We weren t just treading water. She helped us make real change, because she is so good. If she didn t know something she could always tap into the resources at Fazzi. I highly recommend Fazzi s Interim Leadership services. -Donna Marrero fazzi.com

11 11 Village Hill Road, Northampton, MA fazzi.com