The Hidden Cost of Free Software

Sure, times are hard.  Recent changes to Medicare regulations and a unco-operative economy are causing many agencies and related home health businesses to seriously consider their futures.  And there is a big trap, out there, ready to snare unsuspecting agency owners and make their jobs even harder for them.

That trap is Free Software.

It must be understood that there are vendors of home health care software that are credible, reliable, and reputable.  But, healthcare is seen as a potential source of profitable business and there are many players that have arrived on the scene, looking for short-term profits, whatever the cost.  These players will develop a product that offers agencies the bare essentials to run a home health care business.  When a customer starts billing, then the software vendor will start to charge for their product. This is OK for start-ups and early-stage agencies.  But what happens is that an agency will lock itself in to a poorly designed system, potentially for a multi-year contract.  They will enter data, train their staff, and incorporate the product in to their agency workflow.  And when that agency is starting to really rock-and-roll with plenty of patient referrals, they find that their software choice is incapable of supporting their business volume.  At that point, it is a hard, and potentially costly decision to change to a different product and so the agency struggles on, with their software choice holding up their business growth.

What is worse is when software companies that essentially give their product away in order to secure longer term revenue, fail to be able to fund on-going research and development.  The product stagnates.  New features and functions quickly become basic expectations.  And that software company's lack of cash to invest in their systems means that their customers suffer - slow and incomplete development, skimpy customer support, mediocre training resources, and, potentially, a company that is forced to go out of business.

Where does that leave its customers?  High and dry with all their patient information stored on the remote servers of a bankrupt software vendor.

So, don't thing that free software is always good software.  Vendors have a business to run, costs to cover, and investments to make in the on-going development of a product for you, the customer, as well as a trained and talented team of customer support staff and trainers, also for you, the customer.

If you are offered a deal that is too good to be true, it probably is.  You are running your business - you know what it takes.  Software vendors have to do the same thing.  No income means a poorly run business that will probably fail.  If you are paying your software vendor for their product, you are helping to guarantee your future success.

Will Your Agency Sink or Swim?

Back in the 1970's, Sir Richard Branson, the founder and chairman of Virgin Atlantic, had opened up his first record stores in London, with the profits he had made from selling used records in the back of his university newsletter.  He was ambitious, and a few record stores in and around London was not his idea of success.  But sales were not where they needed to be.  He could do one of two things - liquidate everything, and declare bankruptcy, or get a loan and overcome his financial obstacles to growth.

With a new injection of approximately $45,000, he bought his first recording studio, put out records of the Sex Pistols and Boy George, and then bought his first Boeing 747 to start Virgin Atlantic Airlines.  Branson is now listed as one of the richest people in the world and has interests in more than 360 companies.

What does this mean to you?

With so many changes to regulations and funding, it can be a tough time for home health care agencies.  It is not uncommon to be completely distracted by the need to cut costs in order to stay in business.  But those agencies that WILL be successful are those that take a broader view.  They understand that they need to "manage" costs more than cutting them. This is most effectively achieved when a business can do more with less, and can re-assign skilled resources to tasks that are more directly profitable.

One of the easiest ways for an agency to manage their costs more effectively is to review the tools that they use to run their business.  Almost every agency has some form of software.  Some applications have been developed to run entire hospitals, doctor's offices, and everything in between.  These are big, expensive, and overkill for most agencies.  Other applications have been developed to do just the essential tasks that an agency would need to perform - 485, OASIS, scheduling, billing.  Many of these have been created and are sold by very small companies with questionable longevity.

There has never been a better time to look at Igea HHC from Indura Systems. A full-service, fully featured home health care solution, Igea HHC is used by hundreds of agencies throughout the United States. Happy customers tell us of their ability to manage more patients with less staff, and, at the same time, make their billing more accurate and cost-effective.

Igea HHC is a professional-grade product with a reputation for high performance, ease of use, and on-going compliance. Indura Systems is dedicated to home health care, at the industry level, and in partnership with every one of our agency customers.

With regular system updates that deliver critical features that touch on all parts of an agency's workflow, Igea HHC customers can be sure of always getting the home health care system they need, to run their business smoothly, efficiently, and profitably.

For a limited time, we are offering some very special payment options to make it as easy as possible for agencies to benefit from Igea HHC. There really is no better time than right now.

Contact Indura Systems today for your no obligation demonstration, and discover why Igea HHC customers are looking forward to 2010!

Valuable Source of Free Training

We are always looking for ways to reduce costs while improving effectiveness, and getting something that is truly valuable, for free, is becoming increasingly rare.

So for those of you who need to recap or train employees on claim/billing-related topics, CAHABA offers a valuable source of free training available for anybody:

https://www.cahabagba.com/rhhi/education/online_courses/index.htm

Indura Systems PPS Outlier Education

In order to give our customers the information and planning they need to be able to Plan to Profit in 2010, Indura Systems is running a series of PPS Outlier Education workshops in our Miami office during December only.

Already, most of these workshops are fully booked but we may add more dates depending on demand.

The workshops will take the audience, step by step, through the changes to outlier rules and regulations, which will come in to force in January 2010.  We will also give all attendees a simple 10 step action plan to help them minimize the impact of these new regulations on their day-to-day business.

To learn more about these workshops, contact our Customer Support line at (305) 675-6704.

CMS ANNOUNCES POLICY AND PAYMENT UPDATES

News that is generating a lot of questions was posted by CMS on October 30, 2009.  Indura Systems customers can be sure that our top-rated customer support team is ready and available to answer your questions on this topic.

A link to the rule can be found below:
http://www.cms.hhs.gov/HomeHealthPPS/HHPPSRN/itemdetail.asp?filterType=none&filterByDID=0&sortByDID=3&sortOrder=ascending&itemID=CMS1230142&intNumPerPage=10

The Centers for Medicare & Medicaid Services (CMS) today announces a 2.0 percent market basket update to Medicare’s calendar year (CY) 2010 home health prospective payment system (HH PPS) rates and modifications to the home health outlier policy. These improvements are evidence of CMS’ continued efforts to ensure appropriate payments, to prevent fraud and abuse, and to protect beneficiaries in the Medicare home health program. Home health agencies (HHAs) receive additional payments (outlier payments) for 60-day home health episodes of care that carry unusually high costs. For CY 2010, CMS will cap home health outlier payments at 10 percent per HHA and target total aggregate outlier payments at 2.5 percent of all HH PPS payments. The current (2009) target for aggregate outlier payments is 5 percent of total HH PPS expenditures. By lowering the total outlier payment target to 2.5 percent, this final rule increases home health base rates by 2.5 percent for CY 2010.

“This final regulation builds on Medicare’s efforts to refine its payment systems while working to reduce waste, fraud and abuse,” said Jonathan Blum, director of CMS’s Center for Medicare Management. “Through the use of up-to-date home health data, it also provides a clearer focus for oversight of the program while encouraging better coordination of Medicare’s home health benefits.”

In this final rule, CMS continues its current policy of a 2.75 percent reduction to national standardized 60-day episode payment rates and non-medical supply factors in CY 2010. Retention of this policy will help offset the increase in the home health case-mix that is not associated with any underlying change in the actual clinical conditions of home health patients. This CY 2010 reduction is the third year of a four-year phase-in of HH PPS rate adjustments, which were made final in the HH PPS Refinement and Rate Update for the CY 2008 final rule.

Historically, home health payment rates have been updated annually by either the full home health market basket index or by an adjustment to the home health market basket index by Congress. CMS uses the home health market basket index – an inflation measurement of the costs of the mix of goods and services offered by home health agencies. The Deficit Reduction Act of 2005 (DRA) provided for an adjustment to the home health market basket percentage update for CY 2007 and subsequent years depending on quality data submissions by HHAs.

Through implementation of new payment and enrollment safeguards, this final rule will reduce Medicare’s vulnerability to fraud, abuse and improper payments. HHAs currently submit Outcome and Assessment Information Set (OASIS) data as a condition of participation in Medicare. Beginning Jan. 1, 2010, the final rule will require HHAs to submit OASIS data as a condition of payment under HH PPS.

CMS is implementing an improved version of OASIS, called OASIS-C, to collect data on all episodes of care beginning Jan. 1, 2010. This data will document important aspects of the patient’s health status including clinical condition, functional abilities, and service needs. As a result, a clinician will be able to capture a clear and accurate picture of the patient which will assist in development of an appropriate plan of care. Documentation provided through OASIS-C also could be used to signal concerns about patient health, encourage preventive care, identify needs for additional patient treatment, and record patient immunizations and vaccinations.

In CY 2010, CMS will publicly report 12 nationally accepted and approved quality measures plus 13 new process measures on its CMS Home Health Compare Web site (http://www.Medicare.gov/HHCompare) HHAs that submit required quality data will receive payments based on the full home health market basket update of 2.0 percent for CY 2010. The home health market basket index percentage will be reduced by 2 percentage points to 0.0 percent for CY 2010 for those HHAs that do not submit the required quality data. For CY 2012, CMS will require HHAs to report, as part of the required home health quality measures, the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Home Health Care Survey for Medicare and/or Medicaid beneficiaries.

To qualify for the Medicare home health benefit, a Medicare beneficiary must be under the care of a physician and: have an intermittent need for skilled nursing care; need physical or speech therapy; or, have a continuing need for occupational therapy. The beneficiary also must be homebound and receive home health services from a Medicare approved HHA.

28th Annual Home Care and Hospice Conference and Exposition

We were delighted to attend the 28th Annual Home Care and Hospice Conference and Exposition in Los Angeles this year.  Our new booth was on display and we enjoyed talking with many visitors about our point of care system, iPOC, and introducing our new EMR product, Igea EMR, due for release in Q1 2010.

Many existing Igea customers visited us to share their delight with Igea HHC, and to offer us valuable feedback on features and functions they would like to see in future releases.  All this information is carefully documented and passed to our research and development team.

A number of visitors asked us about OASIS-C and ICD10 and we were happy to reassure them that our entire product line will remain compliant through all future changes to these standards.

Janet Rosta from the Baptist Memorial Health Care Corporation in Tennessee was the lucky winner of our Dell Mini 10 Netbook, a special prize awarded to all those who visited our booth and could answer 5 questions about Indura Systems and Igea HHC.  Congratulations to Janet.

A new newsletter will be distributed soon and will include some exciting updates and screen shots of our trade show attendance, and our Igea EMR beta release.

Medicare reimbursement for H1N1 vaccine vs. seasonal influenza

The Influenza vaccine for 2009 is reimbursed on reasonable cost, while the Influenza administration rate is reimbursed on the wage adjusted outpatient prospective payment system (OPPS) reimbursement rate.

The OPPS reimbursement rate for 2009 is $24.89. The rate is wage adjusted where the labor portion is 60% and non-labor portion is 40%.

The H1N1 vaccine is to be provided at no charge to providers therefore, there will be no provider reimbursement for the H1N1 vaccine. Medicare will reimburse providers for the administration of the H1N1 vaccine at the same rate as the influenza vaccine administration rate. Home health providers will be reimbursed at the wage adjusted amount for $24.89.

For example, in 2009, the national unadjusted payment rate is $24.89.  If the wage index for the applicable CBSA is .99, then the payment to the HHA would be $24.74

$24.89*.6=$14.934 (the portion to be wage adjusted);

$14.934*.99 (the wage index) =$14.78466 (the wage adjusted portion of the payment)

$14.78466+$9.956 (the 40% of the national unadjusted payment that is not wage adjusted) = $24.74 (after rounding)).

Home Healthcare Focus - August 2009

We are pleased to announce the publication of our August 2009 newsletter, Home Healthcare Focus.

This issue covers:

• Reacting to the Health Care Debate
• How Home Health Care Saves Billions of Dollars
• CMS Boosting Home Health Payments
• Increase in Drug Plan Premiums for Medicare
• Avoiding Falling in to the Trap of False Economy
• Health Insurance Reform Affecting Services

As well as our latest product news, tips on using Igea HHC, and our latest company news.

Read the newsletter here.

CMS issues proposed home health payment rule

The Centers for Medicare & Medicaid Services on July 30 proposed a net decrease of -0.86% in Medicare payments for home health agencies in calendar year 2010. This includes a 2.2% market basket update, which would be decreased by 2.75% as part of a four-year series of cuts that adjust for coding changes between 1999 and 2005. In addition, the rule states that CMS is considering additional coding reductions, based on further analysis of case mix change, that could lower 2010 payments by -4.90.

The proposed rule would also cap outlier payments at 10% per agency and limit total outlier payments to 2.5% of total HH PPS payments. The rule will be published in the Aug. 6 Federal Register with comments accepted through Sept. 28.

Home health agencies (HHAs) receive additional payments (outlier payments) for 60-day home health episodes of care that carry unusually high costs. CMS proposes to cap outlier payments at 10 percent per agency and target total aggregate outlier payments at 2.5 percent of total HH PPS payments. Currently, the target for outlier payment targets is 5 percent of total HH PPS payments. As such, CMS reduces home health rates by 5 percent to fund outlier payments. By lowering the total outlier payment target to 2.5 percent of total HH PPS payments, CMS would increase home health rates by 2.5 percent.

Read the full article.

Presidential Report Confirms Health Care Jobs On The Rise

We didn’t have to read the new jobs report from Obama’s Council of Economic Advisers to know that health care’s going to add a lot of jobs over the next several years.

But we were interested in the report’s finding that the biggest job growth of any category in the economy would come not for doctors, nurses, or nursing home workers, but for a broadly defined group called “other medical services and dentists.”

The report defines that group as “a broad category including the ever-expanding home health care, outpatient care, and medical and diagnostic laboratories subsectors,” and projects more than 2 million new jobs per year for the group, on average, between 2008 and 2016.

A separate projection looks at the growth of health-related jobs versus all other occupations between 2000 and 2016. The finding: 12% growth for “other occupations”; 35% growth for “health practitioners”; and 48% growth for “health care support.” Health care support includes physical therapists, physical therapist assistants, medical social workers and home health care aides, the report says.