Eli's Hospice Insider

Published on Thu Apr 16, 2015 PDF

Access your benchmarking data — before regulators do.

You should have an idea of whether your data makes you stick out like a sore thumb, now that your newest PEPPER report is available.

Program for Evaluating Payment Patterns Electronic Report (PEPPER) contractor TMF Health Quality Institute made hospice PEPPER reports available April 9, a bit ahead of its announced due date of April 13.

Old: Like previous PEPPER reports, this one compares your data on live discharges and long lengths of stay to hospices in your state, MAC region, and the nation.

New: New to the report are data on Continuous Home Care (CHC) provided in an assisted living facility; routine home care (RHC) provided in an ALF; CHC provided in a skilled nursing facility; and RHC provided in a NF.

“These PEPPER target areas were approved by [the Centers for Medicare & Medicaid Services] because they have been identified as being potentially at risk for improper Medicare payments,” an updated PEPPER User’s Guide explains. “The [HHS Office of Inspector General] found concerns relating to overutilization of hospice services for beneficiaries residing in an ALF. Hospice services to beneficiaries residing in a SNF or NF are also at risk for overutilization. Therefore, there are target areas focusing on these concerns.”

Tip: “When the hospice’s percent is at or above the national 80th percentile for a target area, the hospice’s percent is printed in red bold” print, the guide explains.

Note: For links to the new User’s Guide, training resources, and distribution information (including how to log in and view your report via the PEPPER Resources Portal), go to www.pepperresources.org and scroll down to the “Hospices” box. Step-by-step instructions for download are at http://pepperresources.org/Portals/0/Documents/PEPPER/PEPPERresourcesorgSecurePEPPERAccesssGuide.pdf.