Author: Maxwell Healthcare Associates
Posted: August 15, 2023
At Maxwell Healthcare Associates we remain committed to providing leading guidance to empower agencies within the unpredictable environment of post-acute care. As the aging population continues to increase, this industry becomes increasingly important yet increasingly volatile. When remaining compliant and providing expert care, agencies must stay up to date with changing regulations and best practices to ensure standards continue to improve. Amid the unpredictability, many agencies struggle to survive; at MHA we see a future where agencies aren’t just surviving but thriving and flourishing. With this mission in mind, we recently wrapped up our first inaugural event, the THRIVE conference. THRIVE is an open-format thought leadership gathering where our fellow colleagues and post-acute leaders meet up to discuss pressing issues and resolutions while sharing thoughts and cultivating new ideas for the future. Many important issues were discussed from operations to staffing to general industry knowledge. With this in mind, here are the main takeaways from the THRIVE conference.
One of the most important best practices in an agency to improve productivity and mediate disparities is centralization. Although often a point of contention when discussed, this process can be a very positive one. It is a common reaction for professionals to believe their responsibilities are decreasing, however a proper centralization leads to positive restructuring. Overall, this restructuring ensures each employee is focused on their point of expertise, ultimately creating smoother operations with increased productivity and decreased opportunity for error. A fully centralized team will improve quality in both clinical care and operations. furthermore, increasing the opportunity for ROI and scalability. There are models of centralization for agencies of all sizes, although adoption may be difficult at first, this process is one of the most important interventions for a future-focused agency.
"A reactionary response to denied claims makes sense as this occurrence is incredibly stressful for providers. A proactive response, namely through QAPI implementation offers an opportunity to overhaul positive results. Scalable QAPI operations increase revenue, streamline operations, and increase both patient and staff satisfaction."
- Michelle Mullins, Business Development Manager at MHA
Claims denials occur for a plethora of reasons, both in and out of the clinician’s control. No matter the cause, be it missed visits, improper documentation, or lack of validation, agencies lose up to 4% of net revenue as a result of this detrimental occurrence. The pivotal aspect of denial reduction lies within a comprehensive quality assurance and performance improvement (QAPI) program that measures compliance and operations through reactive measures. Ultimately, this program creates the foundations of a proactive performance improvement process.
Following data collection and analysis, performance improving projects (PIPs) empower active growth. A comprehensive QAPI program further creates the mechanisms of ongoing monitoring to remain fully transparent. Following the success of QAPI, the proactive agency should consider supplementation through tech-enabled services. Full avoidance of denials is then achievable through staff education, collaboration, and documentation.
"Analytics in the post-acute space are so much more than operational information and clarity. A proper analytical program, melded with a company culture that values this information uncovers the “whys” of operations. Useful data identifies points of contention while empowering actionable, data-driven solutions"
- Scott Beard, Chief Strategy Officer at MHA
Detailed and proper analytics offer unparalleled insights in any business, this convention is even more important in an industry as complex as post-acute care. With the normalization of AI, analytics have newfound abilities to make data-backed predictions for patient needs. Agencies can offer recommendations, create proper interventions, and mediate complications using predictive technology enabled through comprehensive data. From an operations standpoint, a transformative data program optimizes scheduling, management, and resource allocation. Overall, agencies that embrace new technology and data best practices will experience unprecedented success in patient care and operations.
"The updated rate cuts from CMS will be detrimental for agencies that are uninformed or underprepared to maintain compliance. Operational oversight, failure of documentation, or poor management are all occurrences that will result in vast payment cuts. During this time agencies must remain united both internally and through the whole industry."
- Tom Maxwell, Co-founder & Chairman at MHA
The updated Hospice Payment Rate Final Rule (CMS-1787-F) for FY24 includes a drastic 4-percentage point reduction in annual payment for agencies that fail to meet requirements. Among threshold updates and program changes, the cut is almost double the previous percentage rate. The 4-percent cut will be detrimental for agencies that fail to meet compliance for reasons like poor LUPA management or under optimized documentation. These cuts hold large implications over the post-acute industry, it is important for leaders to remain united and focused on improving care for all beneficiaries in the system.
"The conversations surrounding the employment shortage always end at recruitment efforts, many agencies never seem to consider how to keep the already limited pool of applicants engaged after onboarding has finished. A restructuring of how we view recruitment provides an interesting opportunity for retention in the post-acute world. I think selection of professionals that align with company culture and goals provides the strongest opportunity for retention."
- Steve Cubis, CEO at HyperCube Recruitment
In a field marked by uncertainty, it's essential to establish a work environment that not only attracts but also retains top-tier talent. By implementing retention-focused recruitment strategies, agencies can proactively identify candidates who align with the organization's values, mission, and long-term goals. Cultivating a workforce that is committed to growth and dedicated to providing exceptional care is a shared objective that fosters stability and resilience. At the root of many issues in the post-acute space lies understaffing or burnout in agencies. Finding qualified staff is one half of the battle, but from there implementing programs to keep them onboard and engaged must become the central focus. Hiring professionals that align with the company culture and goals is just as important, if not more important than the resume qualifications when ensuring longevity. Agencies should also consider growth and development programs, and comprehensive compensation packages to retain employees while experiencing productivity and success.
The post-acute space is unlikely to become any more predictable in the near future which is why it’s essential for leaders to collaborate with the goal of future-oriented success. The issues of retention, rate cuts, under-optimization, and burnout remain problematic, but MHA is here to help. If you would like to learn more about the topics discussed at THRIVE, or are ready to take your agency to the next level, contact us at [email protected] or visit www.maxwellhca.com.