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Home Health Plans of Care: A Guide to Success

Home Health Plans of Care: A Guide to Success

What Makes a Good Plan of Care?

A good plan of care will be able to identify the needs of the patient and set a clear path for managing their condition moving forward. An effective plan of care must:

1.) Identify the patient’s needs
2.) Address their current problems and a path to managing these problems
3.) Continually evaluate the patient’s progress and response to care

A Systemic Approach

To compose plans of care that can effectively guide patient care, it is good to break down the process of creating care plans into steps. This systemic approach provides a blueprint for the best ways to identify patient needs and provide them with care to meet their goals. The systemic approach includes:

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What the Possible Return of Pre-Claim Review Demonstration Means for Home Health Care Agencies

The Return of the Pre-Claim Review Demonstration: What is Different?

CMS recently announced that they are planning to introduce a revised version of the PCR program. Once again, Illinois will be the first state targeted. The updated program is designed to give providers more choice and flexibility with submitting their claims and reward providers who demonstrate compliance with CMS home health policies. Under the new plan, providers have three choices of how to go about their claim review. HHAs may choose to undergo either pre-claim review or post-payment review. Providers may also choose to skip out on either options and instead simply face “minimal post-payment review.” However, the latter option will result in a 25% payment reduction. Like in the original version of the initiative, PCR does not require any additional documentation than what is standard for claim review.

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