Home Health & Hospice Week

But the hospitalization change takes place only on your CASPER reports.

Your hospitalization and emergency department outcome measures may get more accurate, now that the source for the information is changing.

Old way: Formerly, home health agencies' CASPER reports and the Home Health Compare website based Acute Care Hospitalization and Emergency Department use without hospitalization on agencies' own submitted OASIS data.

New way: Now, HHAs' CASPER reports include claims-based ACH and ED use measures, Robin Dowell of the Centers for Medicare & Medicaid Services said in the Aug. 22 Open Door Forum for home care providers. The CASPER reports also include the OASIS-based ACH measure, but the OASIS-based ED measure is gone from the report altogether, Dowell added.

The OASIS-based ED measure will also be eliminated from Home Health Compare starting in October, a CMS source explains to Eli. CMS finalized the move to remove the OASIS-based ED measure last year.

CMS still bases the ACH measure on Home Health Compare on OASIS data, but it may not for long. CMS has proposed to change that to a claims-based figure in the 2013 prospective payment system proposed rule. The change would take effect in January, if finalized.

The claims-based figures are drawn from the April 2011 through March 2012 time period, Dowell pointed out. You may have to be a bit patient, as CMS continues to work out some glitches with the figures, she added.

Revealed: Medicare Advantage patients will not be included in claims-based outcome figures, Dowell confirmed in response to a question from Interim Healthcare's Barbara McCann.

Plus: Home Health CAHPS patient satisfaction data now also displays on the Home Health Compare website, CMS's Debra Dean-Whittaker pointed out in the call.

Other HHA topics addressed in the forum include:

• Outliers. As multiple Medicare Admini-strator Contractors already had reported, a fix for CMS's outlier cap calculation problem has been successful, noted the agency's Wil Gehne in the forum. The correction took place in July (see Eli's HCW, Vol. XXI, No. 28).

"Most home health agencies should have seen payments from those claims adjustments by now," Gehne said. "If you haven't, you will shortly."

Do this: However, the mass adjustments run on 2010 to 2012 claims were "not entirely successful," Gehne acknowledged. Some claims had gone to offline archive storage at the MACs and thus weren't restored and properly adjusted. "If you have found that there are some adjustments that you were expecting to see that you haven't seen ... please contact your Home Health & Hospice MAC and they will bring those claims back online and perform those adjustments for you promptly," he instructed.

• PPS final rule. CMS expects to publish the 2013 PPS final rule in "early November," said CMS's Hillary Loeffler. In the proposed rule published in the July 13 Federal Register, CMS proposed some drastic changes to survey and enforcement procedures focused on alternative sanctions (see Eli's HCW, Vol. XXI, No. 26). Other changes proposed include therapy visit ranges, a data collection tool for hospices, and 2013 payment rates (see Eli's HCW, Vol. XXI, No. 25).

• OASIS-C. CMS still hasn't received Office of Management and Budget approval for its OASIS-C form, but that doesn't mean it's expired. The OASIS-C form does display a July 31, 2012 expiration date, Dowell acknowledged. But back in March CMS submitted a Paperwork Reduction Act package, which requested no changes to the form, to the OMB for approval. "The approval of the existing package will continue until OMB gives us their response," she explains.
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• PECOS. CMS really wants providers to move to an electronic-only system of enrollment via PECOS. CMS has made a number of changes to the system to increase its user-friendliness, noted CMS's Mark Majestic in the forum. "The whole focus is to try to increase the usability of PECOS and to get people away from having the need to submit paper copies, paper documents, and try to do that all-digital process."

As of Aug. 20, PECOS began accepting supporting documentation via its new document upload feature, Majestic pointed out. Now providers can submit or adjust their PECOS enrollment "100 percent online."

CMS makes many system changes based on provider feedback, Majestic said. We want to make these improvements into PECOS so people will go to PECOS and do it electronically rather than submit those paper documents."

By the way: CMS didn't provide information in response to a question about when claims edits requiring physicians' valid PECOS enrollment would begin. Such edits have been long delayed, but the agency seems to be signaling the edits may take place soon (see Eli's HCW, Vol. XXI, No. 20, p. 158).