For-Profit Hospice Chain Sees Loss In Second Quarter
Published on Thu Aug 12, 2004
Hospice powerhouse VITAS sees another quarter of stellar earnings.
VistaCare Inc. is learning some hard reimbursement lessons from its most recent quarter.
The Scottsdale, AZ-based for-profit hospice chain recorded a loss of $1.8 million on revenues of $48.1 million for the quarter ended June 30. That's in contrast to its competitors, with VITAS Healthcare Corp.'s $7.8 million profit and Odyssey Healthcare Inc.'s $9.3 million profit for the same quarter.
VistaCare blames the majority of the loss on problems with its Medicare caps. The company accrued $6.2 million for its Medicare cap reserve for the quarter, and expects to accrue another $3.5 million for cap overages next quarter, it says in a release.
VistaCare's patient mix dropped to only 25 percent cancer patients, pushing its length of stay (and thus reimbursement per patient) higher than expected. Vista-Care's average LOS for the quarter was 114 days, compared to 79 days for Odyssey and 59.9 days for VITAS.
Increased sales and marketing costs and tax changes also impacted VistaCare's bottom line, the company says. VistaCare has undertaken a program to increase admissions and achieve a better patient mix to minimize cap problems.
Meanwhile, VITAS, a division of Chemed Corp., touted its $7.8 million profit figure on $130.2 million in revenues for the quarter. Net income was up 81 percent and revenues up 23 percent over the same period in 2003, VITAS says.
Given its success, VITAS plans to accelerate its "new starts" and continue to explore strategic acquisitions. VITAS recorded an average daily census of 8,581 for the quarter while VistaCare reported a 5,184 ADC. Hospices could have one more way to generate revenues starting Jan. 1.
The Centers for Medicare & Medicaid Services is proposing to cover a one-time evaluation and counseling session from a hospice medical director or hospice-employed physician for end-of-life services, according to the proposed 2005 physician fee schedule published in the Aug. 5 Federal Register. Payment requires that the patient be terminally ill with a six-month prognosis and has not elected the hospice benefit.
CMS expects most non-hospice beneficiaries will receive end-of-life services from their own physicians. Thus, CMS is going to monitor the data for "duplicative services." If finalized, the new payment will go into effect Jan. 1.
It may now be easier to contact another Medicare provider about claims issues, if Palmetto GBA is your regional home health intermediary. In situations such as overlapping prospective payment system episodes, when you need to contact the other home health agency blocking your billing, you can call Palmetto's Part A Provider Service Center Interactive Voice Response (IVR) system at 1-877-272-5786 and select option 6 to obtain the provider's phone number, Palmetto says in a posting on its Web site.
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