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Expect States to Take Control of Health Reform
By:SWilliams - - 07/09/2010

46 states face budget shortfalls. Can they afford health reform? Read More..

Health Reform, Is Your Company's Plan Grandfathered? Be careful.
By:ReadyConsultant - - 07/07/2010

Employers who offer health coverage have many new requirements to understand related to the recently passed Affordable Care Act. Most of the major changes do not become effective until January 1, 2014 particularly given the "grandfathered" status. However, maintaining this status may be more diffic... Read More..

What's Next for ONC's Agenda with EHR's, Certification and more?
By:DWillcutts - - 01/21/2010

Information Week's recent interview with ONC's Dr. David Blumenthal provided some interesting insights into what is next and who is out there to help providers realize these goals. Where are the meaningful use guidelines? What about the certification process and who will be certifying? And is there... Read More..

NHIN Re-thought? ONC's Dr. David Blumenthal is re-envisioning
By:DWillcutts - - 01/21/2010

The six year effort by the government to create a National Health Information Network through efforts such as RHIOs is getting a fresh look. Is there practicality coming out of Washington? Or is this another twist in the road to a far off dream? At first glance, having a focus on smaller providers'... Read More..

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HHAs and 10 percent outlier cap: Minimize the risk

ReadyConsultant - Angela Martin - 12/31/2009

There are tough times ahead for home health agencies affected by the 10 percent outlier cap. Here’s how you can lessen the policy’s impact on your agency:

  • You need to find out right away if your payments will be limited, recommends Abilene, Texas-based financial consultant Bobby Dusek as the 10 percent per agency cap will start applying immediately in January. 

Author: Angela Martin

Dusek advises that an agency can look at their total outlier payments as a percentage of their total reimbursement to see if they might have a problem. He stresses that since the cap will affect episodes that have already begun, agencies need to look at their situation now. 

  • If there are chances of exceeding the 10 percent mark for outlier payments, you need to act now to mitigate the financial impact. The National Association for Home Care & Hospice suggests that you can explore alternative treatment plans with physicians such as using insulin pumps, changing insulin frequency or employing alternative wound therapy.
  • Your clinicians can explore alternative options like new training approaches to teach self-management or use of assistive devices, NAHC offers. She relates that for low vision patients, Gaboury’s clients found a low vision program to enroll them in that taught them to self-administer insulin.
  • NAHC counsels that your social workers can find other sources of care such as churches or volunteer groups.
  • If you are not in one of the high-suspicion areas, you can look out for other agencies in your area with room under their outlier caps to take on some of your outlier patients.
  • Put a stop on outlier patient admission. NAHC says that you should try to limit admission only temporarily.
  • If you must discharge patients, be sure to adhere to any state rules and your own agency rules for discharge. The trade group adds that you should try to give patients and caregivers advance notice of the possiblity of discharge so that they and their families can work with you on alternatives.

    About the Author:

    Provides free weekly newswire for home health agencies in healthcare and offers learning opertunaty about HHA Reimbursement that keeps connected to the latest developments in health-oriented services.

    Article Source: - HHAs and 10 percent outlier cap: Minimize the risk



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