Home Health & Hospice Week
DON'T LET PAYMENT ADJUSTMENTS DO PROFITS IN
Mine deep into data for more insights.
You may be on your way to enhanced profits by the dashboard light if you're benchmarking, but be sure you have a full understanding of payment adjustments to make the most of the data in the dashboard outlined above.
Adjustments you should be scrutinizing include the following, says Mark Sharp, a partner with BKD in Springfield, MO:
• LUPAs. The industry average for low utilization payment adjustments is 12 to 14 percent. If your agency's number runs higher, consider what's driving the number. Does a particular referral source send you many patients that have a protocol requiring four or fewer visits, for example?
• PEPs. The industry average for partial episode payments is 1 to 2 percent. If your average is higher, consider these questions: Is another agency already caring for the patient? Are you discharging too soon?
• SCICs. The industry average for significant change in condition adjustments is 1.5 to 3 percent. A higher rate could mean that your agency is losing thousands of dollars in inaccurate SCICs, says BKD's M. Aaron Little.
Tip: Remember that you don't have to claim an SCIC unless an unanticipated improvement in the patient's condition decreases the HIPPS codes, the Centers for Medicare & Medicaid Services instructs.
Home Health & Hospice Week
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DON'T LET PAYMENT ADJUSTMENTS DO PROFITS IN
Mine deep into data for more insights.
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