The Home Health Care Wire
Your source for CareVoyant and industry news. April 05, 2023
Keys to Effective Revenue Cycle Management for Home Care
The Revenue Cycle Management (RCM) process starts at intake and continues through authorization, scheduling, billing, and collections. Home Care Agencies must integrate the RCM process with operations to capture, bill, and collect revenue for all the services provided. Agencies should review the RCM process periodically and adjust the process to accommodate the changes in the patient and payer mix.
Home Care Agencies must leverage technology and software to automate repetitive and time-consuming revenue cycle tasks. Management by Exception throughout the RCM process will help home care agencies to do more with less.
This blog will discuss some critical features Home Care Software requires to manage revenue and collections to improve cash flow and the bottom line.
Through Consumer Directed Services programs, patients can hire their caregivers and manage their schedules for services authorized by Medicaid or Medicaid Waiver programs. Even though the patient can employ the caregiver and schedule the services, home care agencies will act as fiscal intermediaries by managing the payroll for caregivers and billing for the services provided.
This unique situation creates unique scheduling challenges for the agencies. Even though the agencies are responsible for billing and paying for the services, they cannot schedule caregivers like regular employees. Since the patients are scheduling the caregivers, agencies will only have exposure to the schedules or control over schedules once the time sheets are received from the caregivers.
Consumer Directed Services are authorized by Medicaid or Medicaid Waiver programs with limits on the number of hours of services provided per day, week, or month. This adds another layer of challenge to home care agencies. They must limit the services provided under authorized hours even though they have little control over the hiring of caregivers and managing their services.
When services go over authorized hours, the agencies face the uncomfortable task of telling the caregivers that they will not be paid for the services provided over approved hours.
Home and Community-Based Services (HCBS) allow Medicaid beneficiaries to receive services in their home or community rather than institutions or other isolated settings. These programs serve a variety of targeted population groups, such as people with intellectual or developmental disabilities, physical disabilities, and/or mental illnesses. Over 3 million individuals receive HCBS through various Medicaid Waiver programs.
Medicaid beneficiaries are increasingly receiving LTSS through HCBS. In fiscal year (F.Y.) 2016, Medicaid programs spent approximately $94 billion on HCBS. The federal government and the states spent $116 billion on Medicaid home and community-based services (HCBS) in F.Y. 2020, serving millions of elderly adults and people with disabilities. That is a significant increase in HCBS spending.
Because states can limit enrollment in HCBS waivers, most states report having HCBS waiver waiting lists totaling over 665,000 people nationally. Proposed additional funding for HCBS will enable states to reduce their HCBS waiver waiting lists and add more people to HCBS. The need for HCBS services will continue to grow in the foreseeable future.
Home Health Care Agencies looking for growth and expansion should consider HCBS services as one of the options.
This blog will discuss some of the essential features required in the software to manage HCBS Home Care Agencies efficiently.
Home Healthcare Industry News
CMS rolls out new resources for quality outcomes, HHVBP
CMS has introduced several new tools for agencies to improve their results in the Home Health Quality Reporting Program, as well as Home Health Value-Based Purchasing.
A new video tutorial walks agencies through GG0170C Lying to Sitting on Side of Bed in the OASIS assessment. CMS also has released BIMS, PHQ-2 to 9 and Pain Interview cue cards as a resource for these sections that have been challenging for clinicians since OASIS-E was implemented in January.
NAHC, HCAOA Unveil Practical Solutions To Address Home-Based Care Workforce Crisis
For the first time ever, two of the largest associations representing the home-based care industry have joined together on a call to action regarding the workforce shortage.
On Monday, the National Association for Home Care & Hospice (NAHC) and the Home Care Association of America (HCAOA) released a report that details the needs of the nursing and home care aide workforces and specifically recommends policy changes and operational practices that can be implemented to address the workforce shortage in home-based care.
Upcoming Events
IHHC Annual Conference
NIU Naperville - April 5-6
Association for Home & Hospice Care of North Carolina
Westin, Charlotte, NC - April 23-25
Missouri Alliance for Home Care Annual Conference
Margaritaville Lake Resort, Osage Beach, MO - April 26-27
ABOUT CAREVOYANT
CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.
CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.
For more information, please visit CareVoyant.com or call us at 1-888-463-6797.