Market Research Letter: January/February 2010
Providing insights for home care and hospice
January/February 2010
In This Issue
Important Note to Customers: 2008 Data Availability
Feature Article: FLOURISHING UNDER HEALTHCARE REFORM (Part 1): Maximize Your Profits by Minimizing the Impact of LUPAs
Metrics Matter: Primary Diagnoses That Provide the Greatest Revenue Potential
Ask the Home Care Data Guru: How Do I Measure Medicare Hospice Utilization?
Proposed healthcare reform legislation is moving forward, threatening the home health industry with significant cuts in Medicare reimbursements. Over the coming months through this newsletter, we’ll suggest new operational strategies to help increase your organization’s profit margins and counter the pending losses in reimbursements.
We begin with this month’s feature — “FLOURISHING UNDER HEALTHCARE REFORM (Part 1): Maximize Your Profits by Minimizing the Impact of LUPAs” — by discussing ways you can improve the management of Medicare patients subject to the Low Utilization Payment Adjustment (LUPA).
Give me a call at 215-657-7373 or email me at info@healthmr.com to discuss new strategies for your organization that will help ensure success for 2010 and beyond.
Rich Chesney
President, Healthcare Market Resources, Inc.
Important Note to Customers: 2008 Data Availability
We recently received the 2008 home health and hospice claims database in raw form from Medicare and are currently building the database. Manipulating millions and millions of records is a formidable task, and the information to produce certain reports is available earlier in the process than others. Further, with the home health claims starting in January 2008, we saw the advent of the “new” Prospective Payment System (PPS) regulations, which dramatically changed the information on the claim. Accordingly, several reports need to be rewritten and possibly an additional report created. In hospice, billing regulations changed as of July 1, 2008, requiring visit information on the claims, similar to home health.
Therefore, we have decided to deliver the report sets in two phases. We anticipate being able to begin shipping the Phase I reports – outlined below – in 3 to 5 weeks. The remaining Phase II reports should be delivered between 5 and 6 weeks after Phase I shipments have been completed.
Phase I Reports:
Home Health – Market Share, Demographics, Diagnosis Mix and Discharge Disposition/Referral Source
Hospice – Market Share I and II, Demographics, Discharge Disposition, Diagnosis Mix, Type of/Site of Care, and Length of Stay
In the Phase II Reports, we will introduce a series of graphic representations of the data as part of our standard report package, which should make our information more understandable for those within your organizations who are more visual thinkers. (The Executive Summary and Excel versions will also be part of Phase II.) Please contact us if you would like samples of these new reports.
We are currently taking orders for 2008 Market Profile Reports and shipments will be made based on their receipt.
Feature Article: “FLOURISHING UNDER HEALTHCARE REFORM
(Part I): Maximize Your Profits by Minimizing the Impact of LUPAs”
Under the different versions of healthcare reform legislation passed in the House of Representatives and U.S. Senate, Medicare home health reimbursement is projected to decline by billions of dollars over the next 10 years. To counter these declines, home health agencies must make some fundamental changes in the way they do business. This article discusses ways you can improve the management of Medicare patients subject to the Low Utilization Payment Adjustment (LUPA) to help maximize your organization’s profit margins.
Read more.
Metrics Matter: “Primary Diagnoses That Provide the Greatest Revenue Potential”
Which primary diagnoses groups offer the greatest revenue potential on a per-patient basis? That’s what we look at in this month’s metric, along with the various key financial indicators for patients with various primary diagnoses.
Read more.
Ask the Home Care Data Guru
Looking for some hard-to-find data? In Ask the Home Care Data Guru, we share questions from our subscribers – and our answers. Send us your question today!
Q: How do I measure Medicare hospice utilization?
A: Traditionally, the hospice industry has measured utilization based on the percentage of deaths on hospice compared to the total deaths or total planned deaths for a given geography. Using the planned death figure eliminates accidents and suicides, since these deaths could not have been candidates for hospice because of their sudden nature. This information can be found at the county and state levels. To use the planned death figure, however, requires a cause of death breakdown.
Read the entire answer.