Market Research Letter: December 2013

Filed under Newsletter

Providing insights for home care and hospice
December 2013

Arrow In This Issue

Feature Article: New Criteria for Post-Acute Network Selection
Metrics Matter: How Diagnosis Codes and Discharge Disposition Data Provide Insight Into Maximizing Hospice Profitability

Thanks to the Affordable Care Act and changes in the insurance market, home care referral lists are getting shorter. Will your agency make the cut? See the new criteria for post-acute network selection in this issue’s feature. Plus, check out Metrics Matter where we show that diagnosis codes and discharge disposition data give insight on how to maximize hospice profitability.

Rich Chesney
President, Healthcare Market Resources, Inc.

Arrow Feature Article: “New Criteria for Post-Acute Network Selection”

Various legislative programs in the Affordable Care Act and other efforts in the commercial insurance market are prompting hospitals, accountable care organizations (ACOs), and managed care organizations (MCOs) to shorten their referral lists. In this new world, the performance of home health agencies, hospices, and skilled nursing facilities can have a financial impact on a referring institution’s bottom line. Although initial selection of participants may be based on softer factors and relationships, the process will quickly evolve into a numbers game because decision makers will view it in terms of WIIFM — “What’s in it for me?” Read more. Read more.

Arrow Metrics Matter: How Diagnosis Codes and Discharge Disposition Data Provide Insight into Maximizing Hospice Profitability


Metrics Matter

Source: 2011 Medicare Claims Data

Click to Enlarge and Read Article

When it comes to maximizing profitability of Medicare hospice patients, the distribution of diagnosis codes and discharge disposition are key metrics for benchmarking and strategic planning. Our analysis indicates that length of stay varies significantly by diagnosis codes and by discharge disposition. Read more.