Has Healthcare Market Resources enhanced its market profile reports in home health and hospice?

Filed under Key Questions
Originally published in Market Research Letter: March/April 2013

Q: Has Healthcare Market Resources enhanced its market profile reports in home health and hospice?

A: Yes. Because of changes in the information required on claims, we have been able to provide greater insight into how your competitors operate their businesses. In home health, for example, the visit codes have been expanded to show the use of therapy aides in physical therapy, occupational therapy, and speech therapy. In addition, nursing visits are broken down, depending on whether the therapy service was part of a maintenance program by discipline and what type of nursing service was conducted during the visit. This gives you greater insight into the clinical practice patterns of your competitors and the market norms. Also, visits for patient and caregiver education are now being segregated through new billing codes.

If your competitors are substituting a lower skill level to deliver their agency’s therapy program, you may be able to use this in your sales efforts. Also, if you devote more effort to patients’ families, this can be promoted as a competitive advantage. A nationally prominent Medicare home health billing expert, Melinda Gaboury, indicated that in her experience, this training code was being underutilized by agencies. So if your agency has been more diligent in coding visits, you may have a competitive advantage.

In hospice, we have changed the way we calculate continuous-care days. Previously, we knew only the hours of continuous care billed. Now since the hours or 15-minute segments of continuous care must be accounted for each day individually, we can quickly determine if a given day met the 8-hour threshold minimum billing requirements for continuous care. This gives the report reader a much more accurate picture of how each hospice uses the various levels of care in its care plans.

Look for more Healthcare Market Resources market profile report improvements in the upcoming months in such areas as Medicare dual eligibles and utilization levels.