Home Health & Hospice Week

Mine deep into data for more insights.

You may be on your way to enhanced profits by the dashboard light if you're benchmarking, but be sure you have a full understanding of payment adjustments to make the most of the data in the dashboard outlined above.

Adjustments you should be scrutinizing include the following, says Mark Sharp, a partner with BKD in Springfield, MO:

• LUPAs. The industry average for low utilization payment adjustments is 12 to 14 percent. If your agency's number runs higher, consider what's driving the number. Does a particular referral source send you many patients that have a protocol requiring four or fewer visits, for example?

• PEPs. The industry average for partial episode payments is 1 to 2 percent. If your average is higher, consider these questions: Is another agency already caring for the patient? Are you discharging too soon?

• SCICs. The industry average for significant change in condition adjustments is 1.5 to 3 percent. A higher rate could mean that your agency is losing thousands of dollars in inaccurate SCICs, says BKD's M. Aaron Little.

Tip: Remember that you don't have to claim an SCIC unless an unanticipated improvement in the patient's condition decreases the HIPPS codes, the Centers for Medicare & Medicaid Services instructs.