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!

President Obama Makes Health Care Reform a Top Priority

March 03, 2009 - by Lynn Shapiro, Writer

The Senate is pitched for battle, having heard the details of President Obama's plans for health care reform, laid out in the speech he delivered to Americans last week.

It is a certainty that every vested interest will lobby against it, especially pharmaceutical companies, which stand to lose huge sums of money now that the Obama administration plans to spend $1.1 billion for new reviews of generic drugs. The move is based on several recent studies showing that generics sometimes work as well or better than newer, more expensive medicines. The budget also calls for negotiations with drug makers to lower their prices, as Canada and Western European countries now do.

This initiative is a radical departure from President George W. Bush's Prescription Drug Plan of 2003 for Medicare beneficiaries (Medicare Part D), which refused to require drug makers to negotiate their prices downward.

Unlike Bush, Obama appears unafraid of impinging on the fortunes of industry. Neither is he averse to taxing Americans in the highest income bracket. The President said that most workers are unduly constrained by health care costs and that to ease this burden, he would derive $318 billion by raising the taxes on the top 20 percent of tax filers who earn more than $250,000 a year. These individuals would pay 90 percent of all taxes.

Obama's proposal would also eliminate subsidies now given to the private plans that provide care to more than 10 million of the 44 million Medicare beneficiaries. By forcing these plans, known as Medicare Advantage, into a competitive bidding process, the administration says it can save $175 billion over the next 10 years.

The President is counting on the economy to be thriving by 2011. Then, his plan for hiking taxes on high-income payers would make it possible for him to keep his promise to halve the deficit by 2013.

Deficits of almost $1.8 trillion in 2009 and $1.2 trillion in 2010 are frightening. But while Obama wants to extend tax cuts for the middle class, much of the health care package is intended to save the economy and create jobs. So, the massive amount of red ink Americans face should be temporary, the budget assumes.

Deciding when to go from stimulus spending to deficit reduction is the trickiest part of the equation, but doing it is essential, analysts say.

Other Provisions

Another avenue for health care savings would come from slashing Medicare's home health care programs, said to be excessive. What's more, ending rebates from drug companies for medicines sold to Medicaid patients would save the U.S. healthcare system almost $20 billion.

The budget also includes more than $1 billion to help the FDA fortify its food safety program because of the salmonella outcry; $6 billion for cancer research and a program to send nurses to new mothers' homes to check on babies. Another $76.8 billion would go to the Health and Human Services Department to fund electronic medical records to end costly duplication of diagnostic tests and allow doctors to share patient histories. This provision is not only cost-effective but potentially beneficial to the patient, experts say. Obama promises to preserve patients' privacy, even while doctors share patients' records.

White House budget director Peter Orszag projected in commentary over the weekend that the proposed spending would save $1.8 billion in 2010, $16.2 billion in 2011 and increasing amounts annually to create a $633.8 billion fund to pay for health care reform by 2018. Congress has already provided $25 billion to help laid-off workers pay for COBRA.

What's more, Obama says that spending to get coverage for more of America's 46 million uninsured will save money, if preventive care helps patients avoid expensive and chronic diseases.

Money will be also be saved, Obama said, by finding and eliminating overpayments in Medicare. "The Government Accountability Office has labeled Medicare as 'high-risk' due to billions of dollars lost to overpayments and fraud each year," the budget reads.

Better Care, Not More

In conclusion, the budget says "about $26 billion can be saved over 10 years by using a combination of incentives and penalties to prevent avoidable expensive readmission when patients go back into the hospital within a month after treatment. Reforming the way doctors are paid will also reduce costs, by paying them to provide better care rather than more expensive care, such as imaging scans and surgery that may not be necessary." For example, since Obama took office, Medicare has announced it will stop covering virtual colonoscopies, deciding they're too expensive.

None of this will be easy but one thing is for sure. President Obama has made health care reform a top priority.

Brought to you by Indura Systems.

House Call Physicians Ineligible for e-Prescribing Incentives

AAFP Efforts Fail to Reverse CMS Decision
By Sheri Porter 2/24/2009

The AAFP's efforts, in tandem with those of the American Academy of Home Care Physicians, or AAHCP, to correct an oversight in CMS' recently launched electronic-prescribing incentive program, recently resulted in a denial from the agency.

Rick Kellerman, M.D., of Wichita, Kan., an AAFP past president, is shown here checking on a nursing home patient.

In a Feb. 9 letter to CMS Acting Administrator Charlene Frizzera, AAFP Board Chair Jim King, M.D., of Selmer, Tenn., pointed out that, as currently implemented by CMS, Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 "precludes physicians who practice predominantly, if not exclusively, as house call physicians from participation in the e-prescribing incentive program." On Feb. 23, however, AAFP News Now learned from AAHCP Executive Director Constance Row that CMS had declined to make the changes recommended by the two organizations.

Relevant CPT Codes Overlooked

The issue lies with the agency's choice of CPT codes that appear in the denominator of the e-prescribing legislation. As King pointed out in his letter to CMS, those CPT codes include services provided in the areas of psychotherapy, general ophthalmological services, health and behavior assessment and intervention, office and outpatient visits, and office consultations. However, CMS failed to include codes typically used by physicians who focus their practices on house call services, said King.

Those codes also include care provided to patients living in nursing homes. King argued that many house call physicians were early adopters of health information technology and e-prescribing. He said patients served by home care physicians usually have multiple comorbidities that call for an array of prescriptions that would be more efficiently handled electronically.According to Row, however, "CMS has decided definitively not to add these codes to the 2009 electronic-prescribing incentive program." She added that the letter from CMS indicated the agency may "consider changes for 2010 or beyond."

Statistics Reinforce Call for Inclusion

Row said that statistics provided by CMS only reinforce the argument that home health care physicians and other eligible providers should have the opportunity to benefit financially from the e-prescribing bonus program. She cited figures from CMS' Physician Supplier Procedure Summary Master Record that details Part B claims paid by Medicare carriers in 2007.According to those data, all Medicare providers combined logged 2,194,083 total house calls and 1,696,411 total domiciliary visits (i.e., house calls to patients residing in assisted living facilities) in 2007.

Family physicians alone logged 410,582 house call visits and 286,521 domiciliary visits in 2007. In his letter, King called on CMS to add home services CPT codes 99341 to 99350 and domiciliary/rest home visit CPT codes 99324 to 99337 to the denominator for eligibility in the e-prescribing incentive program.Row said that in light of CMS' rejection of that suggestion, her organization would continue to work closely with the AAFP for possible resolution of the issue in 2010.

Brought to you by Indura Systems.

Care Givers on Bikes!

Brought to you by Indura Systems.

Gentiva to divest six home healthcare branches to Loving Care Agency

By Datamonitor staff writer

Gentiva Health Services, a provider of comprehensive home health services, has entered into an asset purchase agreement with Andventure, doing business as Loving Care Agency and Links2Care, for the sale of six Gentiva branch offices in four cities that specialize in pediatric home healthcare and also provide adult home health aide services.

These offices comprise more than 80% of Gentiva's current pediatric care operations. Terms have not been disclosed. According to Gentiva, the transaction fits with its stated objective of increasing its focus on skilled home health services for geriatric patients.
Under the terms of the transaction that Gentiva has announced, Loving Care Agency will acquire existing Gentiva branches in Phoenix, Arizona; Springfield, Massachusetts; Pittsburgh and State College, Pennsylvania. The transaction is expected to close in the first quarter, subject to all customary approvals.

Tony Strange, CEO of Gentiva, said: "This agreement with Loving Care, a leader in pediatric homecare services, will build on the high quality of care that these branches have provided. Our decision to migrate away from pediatric home healthcare is in keeping with the company's strategy of focusing on geriatric specialties.

"We believe our emphasis on providing value-added services to this population will translate into higher margins and returns that we can leverage to continue to grow our core home health business."


Brought to you by Indura Systems.

Good News from Palmetto - GBA RESOLUTION ACHIEVED

Claims Submitted through Direct Data Entry in Status/Location SM95HG

Palmetto GBA just announced that claims that were submitted through direct data entry (DDE) and are pending in FISS Status/Location SM95HG have been corrected and are being released for processing. These claims were submitted via DDE between November 3, 2008, and December 2, 2008 and received a duplicate document control number (DCN). PalmettoGBA is keenly aware this issue has affected sequential billing for some Home Health and Hospice providers. Once the affected claims begin to process to completion sequential billing can resume.

Previously issued accelerated payments are scheduled for recoupment beginning March 2, 2009.

To learn more about the resolution to this matter and others, we encourage you to visit the Palmetto GBA RHHI Claims Processing Issues Log located at this link.

Brought to you by Indura Systems.

Home Health Care - the business to start!

It's official - Home Health Care is one of few businesses that can survive the current economic crisis. Here is what the blog biziki.com has to say about Home Health Care:

While employment in the health service industry is projected to grow 28% by 2012, employment in the specialized home health care industry is expected to be
nearly twice that, or 54.5%. Each year, over 7.6 million people are provided with home health care services.

Thanks to science and medicine, people are living to a ripe old age more and more. This means, however, that more people are needed assistance at home. And that is where home health care comes into the picture.

Just think, 7.6 million people, 6 episodes per year, $3000 per episode - that is potentially a $136,800,000,000/year industry.
Want a bigger slice of that pie?
Find out why Igea HHC from Indura Systems is THE PREFERRED home health care agency management system for more customers throughout the United States.
Read the whole blog at http://www.biziki.com/biz/top-industries-to-start-a-business/.
Brought to you by Indura Systems.

NEWS RELEASE: Joint Commission - Jan 20, 2009

The Joint Commission to Include Patient Satisfaction Data on Quality Check™
Web site provides new information to help patients make decisions

(OAKBROOK TERRACE, Ill. – January 20, 2009) People seeking information about how patients perceive the care they received at a particular hospital can now find this information on The Joint Commission’s Quality Check™ Web site, http://www.qualitycheck.org/.

The Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) data from the Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare Web site is posted on Quality Check™ beginning this month. This information will be updated quarterly.

HCAHPS information comes from patient ratings of communication with doctors, communication with nurses, responsiveness of hospital staff, cleanliness and quietness of the hospital, pain management, communication about medications, and discharge information. In addition to information about patient satisfaction, Quality Check also includes data from CMS on 30-day mortality rates for heart attack, heart failure and pneumonia.

Thousands of people use Quality Check each month to find information about the more than 15,000 accredited health care organizations that have earned The Joint Commission “Gold Seal of Approval.” Quality Check provides details about an organization’s accreditation status, efforts to prevent medical mistakes by complying with National Patient Safety Goals, and comparison information about how hospitals comply with National Quality Improvement Goals such as giving heart attack patients aspirin within a specified timeframe.
Brought to you by Indura Systems

Introduction to Indura Systems

Home health care is one of the most regulated industries in the United States. Any organization that is associated with the health care industry is also open to aggressive litigation.

Any health care organization could spend considerable time understanding, and keeping track of, all the rules and regulations that apply, and are regularly being amended. With a fluctuating economy and shifts in age demographics, agencies are increasingly being expected to perform better with fewer resources.

Indura Systems understands the home health care industry from the agency perspective. Igea HHC, from Indura Systems, gives our customers the essential tools to achieve three things:

1. To focus on running their business effectively, and with lower overheads
2. To adhere to constantly changing regulatory controls including data security measures
3. To minimize time to reimbursement of payments from Medicare, Medicaid and/or Private Duty.

Igea HHC can deliver these benefits because the system has been built on a rugged, tested, and proven workflow model. The system is not only simple to use and easy to tailor to individual agency needs, but also helps maximize profit and shield agency staff from much of the complexity of home health care administrative tasks.

Contact us at Indura Systems to learn more about how we partner with home health care agencies to support and optimize their business success.