Advanced Search

Home Health & Hospice Week

Prospective Payment System:

Use These 3 Steps To Keep Your Outliers Under Control

Published on Tue Mar 09, 2010

Don't be afraid to admit outlier patients. Home health agencies with large outlier populations should avoid knee-jerk reactions to the 10 percent cap or risk facing survey and other troubles. HHAs that have a large percentage of outlier patients -- often blind, insulin-dependent diabetics who require multiple insulin injections daily -- are managing their outliers with various strategies."Some outlier-focused companies are changing their patient mix," William Dombi with the National Association for Home Care & Hospice tells Eli. Others are focusing on teaching family members or other caregivers how to do the injections and teaching patients themselves to be more independent, Olson says. (For ideas on minimizing outlier risk, see Eli's HCW, Vol. XVIII, No. 43, p. 331.) Agencies that are just now getting hit by the cap need to be careful to avoid patient dumping charges that arise from discharging outlier patients, cautions Lynn Olson with billing company Astrid Medical Services [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Home Health & Hospice Week

View All