How To Prepare for CMS’ New CoPs for Home Health Agencies

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Effective July 13th, CMS’ new Conditions of Participation (CoPs) is the first update in roughly 20 years to the minimum health and safety standards a home health agency must meet in order to participate in the Medicare and Medicaid programs.

Who should care about the new participation rules?

  • More than 5 million Medicare and Medicaid beneficiaries
  • Nearly 12,600 participating home health agencies

Why are these changes needed?

  1. To provide the first comprehensive update to the HHA CoPs defining the fundamental requirements for Medicare and Medicaid participation in decades
  2. To ensure the nationwide implementation of well-accepted and recognized best practices for in-home care
  3. To leverage patient-centered, data-driven, and outcome-focused processes that enhance the quality of care for all patients

What does this mean for Home Health Agencies?

The rule will specifically require better coordination, communication, and agency quality assessment, and is estimated to cost $293.3 million to implement in the first year and $290.1 million in subsequent years. Home Health Agencies will need to dedicate significant resources to meet requirements for the following:

  • Integrated, coordinated care

All care delivery and support need to be documented and coordinated by a designated licensed clinician. The clinician will be responsible for all the patient care services, such as coordinating referrals and assuring customized care plans.

  • An integrated communication system

A system must be put in place to ensure that a home health agency and patient’s physician actively communicate and share relevant patient care information with each other.

  • A quality assessment and performance improvement program (QAPI)

HHAs must adopt the QAPI program to continuously evaluate and improve the care provided by the agency through a data-driven, agency-wide program.

How to Prepare?

With only a few months left to prepare, HHAs will need to focus on adapting their processes, retrain staff, and evaluate viable technology options. In particular, those processes pertaining to care management, care coordination, interdisciplinary team communication, data collection, and reporting will require the most attention and redesign. Process improvements and new technologies considered will need to drive:

  •  Data sharing across EHRs
  •  Customization
  •  User-friendliness
  •  Care coordination
  •  Collaboration
  •  Visibility & accountability

To learn how CipherHealth can help meet the new CoP requirements, get in touch with us.



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