Eli's Hospice Insider

Published on Fri Mar 22, 2013 PDF

‘Live Discharges’ change welcomed by hospices.

It may seem like you just got your first hospice PEPPER report, but it’s nearly time for another one. This one may look different, however.

About three-fourths of the nation’s hospices received a Program for Evaluating Payment Patterns Electronic Report (PEPPER) comparative billing report last August (see Eli’s Hospice Insider, Vol. 5, No. 9). Now PEPPER contractor TMF Health Quality Institute will be sending new hospice PEPPER reports by April, it notes on its website.

Exception: Hospices that don’t have enough data will not receive reports, TMF notes. “Due to data restrictions established by CMS, provider data are not displayed in a time period in PEPPER in any given target area if the numerator or denominator is less than 11,” the contractor explains. “This data restriction may result in a small number of providers either not receiving a PEPPER … or their PEPPER may not display data in some time periods for some target areas.”

The newest version of the reports includes some changes, TMF notes on its website. It has posted a nine-minute training video reviewing “changes in the time periods included in the PEPPER, changes in the way claims are evaluated for inclusion in the PEPPER, and a change in the “Live Discharges” target area definition.

Details: Thanks to billing changes that took effect last summer, the report will now exclude transfers, revocations, discharges for cause, and patients who move in its “Live Discharges” measure, TMF notes in its revised User’s Guide.

The other hospice target area is long lengths of stay. TMF plans to issue hospice PEPPER reports annually going forward.

Note: More information, including the User’s Guide for the new edition of the report and the new training session, is at www.pepperresources.org — click on the “Training & Resources” link in the top bar.