Home Health & Hospice Week

The reduced reimbursement wave for hospice is going to sink some providers, but these tips could help your program stay afloat.

1. Perfect your billing. "Providers must have accuracy in their billing procedures," advises Jeff Lycan with the Ohio Hospice & Palliative Care Organization. Especially tracking claims, and billing appropriately and in a timely manner. That will require knowing eligibility, billing and other Medicare and Medicaid rules "inside, outside and upside down," Lycan notes.

For example: Don't forget to split your claims come Oct. 1, counsels the National Association for Home Care & Hospice. If you fail to split the claim by fiscal years, Medicare will pay the entire episode based on the lower 2008 rate.

2. Improve documentation. "Documentation is always a leading cause of payment denial," Lycan notes. "It is one of the most basic tools we utilize, yet it also appears to be one of the often underutilized tools in caring for our patients."

Hospices should focus on educating all members of the interdisciplinary team on proper documentation that paints a picture of the patient, he urges.

Watch for: The Centers for Medicare & Medicaid Services may combat the documentation shortfalls with an assessment tool for hospice patients that would look similar to OASIS, Lycan predicts.

3. Beef up programs funded by other payors. Lower Cape Fear Hospice in Wilmington, NC, plans to expand community classes not paid by Medicare if the cuts go through, CEO Laurie Myles told the Wilmington Star-News.

4. Know your numbers. It's not enough to just look at benchmarks such as average and median length of stay, Lycan says. "Managers need to understand fiscal data and patient flow to understand how it affects their programs day to day," he urges. "A manager needs to dig deep and understand how it affects their individual program."

Knowing specifics like what kind of patients are on service and what types of patients are in their service area will help managers plan for the future, he says.

5. Pursue efficiencies. Lower Cape Fear Hospice will have to find ways to become more efficient under the cuts, Myles told the newspaper. And it won't be alone. Hospices will have to examine their own processes to find places to cut fat.

Some hospices are already undertaking hiring freezes and layoffs due to the combination of the looming rate cut and higher operating costs, reports Paul Ledford with trade group Florida Hospices and Palliative Care. "It will certainly be difficult, and even heartbreaking, as [hospices] make the tough choices ahead."