CY2024 CMS ĀĢ²čapp Final Rule
ĀĢ²čapp Has the Tools to Help You Thrive
Overview
CMS released the CY2024 ĀĢ²čapp Final Rule on November 1, 2023. While the ruling reflects an aggregate increase in payments of 0.8% in the near term, CMS maintains that it overpaid home health agencies during the first three years of the Patient-Driven Groupings Model (PDGM) and is seeking additional permanent, negative adjustments. Read the major provisions of the rule and its key impacts on home health providers.
Strategic Analysis and Provider Guidance
Hear from Medicare home health industry experts as they discuss the final rule's impact on providers and access to patient care, share recommended legislative and advocacy strategies and offer clinical and operational action items home health providers can implement instantly to help minimize the looming financial impact on your business.
Revenue Risk AnalyzerĀ
The ĀĢ²čapp Revenue Risk Analyzer Dashboard doesn't just react to changes ā it proactively predicts and responds to them quickly, empowering organizations with the strategic insights needed to deliver long-term financial stability and resilience.
This customized dashboard will help guide your organization and provide an āinsights to impactā view of important changes that will have both immediate and future impacts on your organization brought on by the final rule. Located within our ĀĢ²čapp Business Intelligence (BI) tool, the Revenue Risk Analyzer dashboard is designed with the agility to help organizations successfully navigate these changes and identify how key aspects of your patient programming and revenue will be impacted.
To access the new Revenue Risk Analyzer Dashboard, existing ĀĢ²čapp BI customers can find it in the financial home health section of the BI solution. If you are not an existing BI user, sign up for ĀĢ²čapp Business Intelligence today.
Hospice Implications in the ĀĢ²čapp Final Rule
CMS is also finalizing several provider enrollment regulatory changes to prevent and address hospice fraud, waste and abuse in the future. CMS believes these provider enrollment provisions related to hospice ownership and management will strengthen protections against hospice fraud and improve transparency. The hospice enrollment-related regulatory changes in this final rule include:
Subjecting hospices to the highest level of provider enrollment application screening, which includes fingerprinting all 5% or greater owners of hospices.
Expanding the HHA change in majority ownership provisions in 42 CFR Ā§ 424.550(b) to include hospice changes in majority ownership.
Clarifying that the definition of āManaging Employeeā in 42 CFR Ā§ 424.502 includes the administrator and medical director of a hospice.
Value-Based Purchasing
Organizations can increase their revenue up to 5% with value-based purchasing (VBP) and thus offset reimbursement rate cuts and improve overall revenue for 2025 during performance year 2023.
In this ĀĢ²čapp eBook, learn how the VBP model incentivizes quality care with higher reimbursements to higher-performing organizations while penalizing lower-performing ones, understand value-based care areas and incorporate strategies to maximize reimbursements and ensure long-term success.
VBP Dashboard within ĀĢ²čapp Business Intelligence
Identify trends that affect VBP revenue
Drill down patient details to further understand outcomes and trends
Pull predictive analytics for early interventions to prevent negative outcomes and protect VBP revenue
Drive VBP scores with performance improvement measures based on KPIs
OASIS Efficiency
The OASIS captures data critical to ĀĢ²čapp Value-Based Purchasing. ĀĢ²čapp has created a comprehensive collection of OASIS-E resources to help you confidently complete the assessment. ĀĢ²čappā OASIS logic and integrations allow for fast and efficient start of care documentation to improve clinical productivity.
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ĀĢ²čapp ĀĢ²čapp Clients
ĀĢ²čapp ĀĢ²čapp clients can access several resources within the solution to help them answer OASIS questions accurately, avoid QA delays and spend more time with patients. The solution includes an integrated OASIS guidance manual and training tools, like the ĀĢ²čapp 15-Minute OASIS.
Learn MoreĀĢ²čapp ĀĢ²čapp Tools
ĀĢ²čapp ĀĢ²čapp users can access several features within the solution to help provide quality and compliant care, protect revenue, ensure workforce efficiency and decrease costs.
Compliance Safeguards
Increased audits and regulatory scrutiny, such as additional document requests (ADRs), can impact cash flow and lead to significant revenue takebacks. Thatās why ĀĢ²čapp has embedded hard stops for items known as potential triggers for ADRs. Itās like having a compliance specialist assist with the documentation.
Agency Set Up enables hard starts to manage quality and compliance
Integrated OASIS tips guide staff to complete compliant documentation
Orders-driven scheduling prevents visits made without orders
Gross Margin Calculator
By forecasting reimbursement at the beginning of care, organizations can adequately plan for resources throughout the episode of care to improve bottom-line revenue.
PDGM Center
Utilize the PDGM Center to view and manage episodic care. Create efficiency for field and office staff and improve HHRG scores for better average monthly revenue. The ĀĢ²čapp ĀĢ²čapp PDGM Center offers the following:
Accessible and straightforward LUPA thresholds to avoid preventable LUPAs with end-of-episode scheduling
Change of Focus form to capture additional revenue based on clinical grouping
PDGM Modeling Tool to help to forecast staffing and workforce management, based on patient acuity and need
Scheduling Center
The ĀĢ²čapp ĀĢ²čapp Scheduling Center helps manage workforce efficiency and revenue capture. Implement hard stops for orders (created in company setup) to prevent visits made without orders and payment. The Scheduling Center supports clinical scheduling by field staff with permissions, saving countless admit times for PRN and on-call visits.
Additional ĀĢ²čapp Solutions That Will Help You Thrive
ĀĢ²čapp Training and Certification
The ĀĢ²čapp Training and Certification Program can help organizations train and retain staff. It leverages industry expertise alongside our full suite of ĀĢ²čapp solution training to provide continuing education and development for leadership and staff at all levels. Organizations can efficiently onboard new team members and create competent, expert users who will feel comfortable utilizing the solution.
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Revenue Cycle Management
Protecting and growing revenue should be top of mind for providers. ĀĢ²čappā revenue cycle management solution automates claims processing so organizations can do more with less and focus on growing their business.
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ĀĢ²čapp Care
Organizations can expand their staffing capacity with ĀĢ²čapp Care. The solution connects providers with qualified clinicians to deliver timely care. Use ĀĢ²čapp Care to adapt to caregiver demand and the workforce shortage without FTE commitment. Reduce recruitment costs and accept more referrals with unlimited supplemental staffing.
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ĀĢ²čapp CAHPS
ĀĢ²čapp is a CMS-approved Consumer Assessment of Healthcare Providers and System (CAHPS) survey vendor for home health and hospice. CAHPS improves patient engagement, provides deeper business insights to increase revenue and drives growth for home health and hospice organizations.
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