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Managed Care Tool Kit
NAHC/HHFMA/HAA Palliative Care White Paper June 2015
HHFMA Medicare Advantage Managed Care Survey October 2014
HHFMA Cost Efficiencies White Paper June 2014
Palliative Care: A Business Analysis of the Pros and Cons of Establishing a Palliative Care Program
HHFMA-sponsored webinar, February 15, 2013.
With special thanks to hosts BKD CPAs and Advisors
Managed Care Cost Assessment Tool
Cost Report Data Reports
The NAHC COST REPORT DATA COMPENDIUM is an in-depth analysis of Medicare cost reports filed by home health agencies since the beginning of the HH PPS payment system in October 2000. NAHC has acquired nearly 150,000 filed cost reports to develop this Compendium.
The Compendium is a valuable tool for providers of services, consultants, health policy planners, home care advocates, investors, and trade associations looking to gain an understanding of the financial status of home health agencies. However, it must be understood this tool is not intended to be used to affect the planning and delivery of care to individual patients. It must be further understood that while the methodology used by NAHC to conduct this analysis has been validated the cost report data used is unaudited.
II. DESCRIPTION OF THE DATABASE
Annually, all Medicare participating home health agencies file a cost report with the Medicare program. An abbreviated report is filed by low/no utilization home health agencies. This database excludes those abbreviated reports and contains only the full reports filed by home health agencies that are actively engaged in providing Medicare services.
Cost reports must be filed within five months of the close of the provider’s fiscal year. In most cases, the provider chooses the dates of its fiscal year. It is NAHC’s experience that approximately one-half of the HHAs choose a January 1 to December 31 fiscal year and that about 30% use a July 1 to June 30 year. The remainder are scattered throughout the calendar year.
The cost reports used in this Compendium come from the public use file maintained by the Centers for Medicare and Medicaid Services.
Cost reports contain a wealth of data. For purposes of this Compendium, NAHC used data on per unit costs, supply costs, service utilization, and Medicare PPS episodes. In addition, overall HHA cost and revenue data is used to calculate overall financial margins. The geographic location of the HHA and its categorization also is utilized.
New Uniform Chart of Accounts for Industry
The National Association for Home Care & Hospice and the Home Care & Hospice Financial Managers Association released The Uniform Chart of Accounts. The purpose of creating a uniformity of financial reporting, Medicare cost reporting and financial analysis will allow for accurate data collection and analysis that can be used for improved business management and in advocacy efforts with the Center for Medicare and Medicaid Services (CMS) and Congress. The Uniform Chart of Accounts provides for all product lines that are considered to be included under their umbrella of Home Care.
The Uniform Chart of Accounts has been completed by a committee made up of members of the Home Health & Hospice Financial Managers Association (HHFMA). The intent of the members of HHFMA’s Uniform Chart of Accounts Committee is that member agencies of both HHFMA and NAHC will review this Uniform Chart of Accounts and make every effort to revise their chart of accounts so as to fall within this recommended structure. This Committee has also included suggested formats for Statements of Revenue and Expense for Home Health Care (Skilled Intermittent services), Hospice, Private Duty, Pharmacy and Infusion Therapy as guides for assisting in the necessary ongoing financial analysis of each specific product line.
This project was originally undertaken by a Joint Committee formed by the Illinois Home Care Council and the Indiana Association for Home Care in 1992. The Joint Committee was co-chaired by Pat Laff and Dave Elwell. Its other members included John Gaynor, Tom Galluppi, Renee Hyde and Elaine Ricci. The joint committee consisted of significantly experienced provider financial executives as well as home health and hospice financial consultants. The project was completed in 1994, but funding for the project was discontinued and its final product was never published. That product formed the basis for the completed and finalized Uniform Chart of Accounts (see below).
Pat Laff, chair of the HHFMA Uniform Chart of Accounts Committee, acknowledged the work and dedication of its members, without whom this result could not have been achieved. The members include Ed Nicolas – VNS of Connecticut, Jeff Kolcum – Family Home Care, Katherine Jones – Guardian Home Care, Mark Tsiames – Simione Consultants, Vern Peterschmidt – Peterschmidt and Associates and Dave Stasiewicz – Addus Healthcare, Inc.