Major Challenges in Hospice and Homecare

Updated: Jul 27



Current day hospice care presents an enormous number of challenges for agencies, clinicians, and patients alike. These challenges are complicated further as a pandemic continues to impact communities around the globe. Concerns around financial constraints, staffing burdens, and documentation concerns endure as the industry evolves. However, these concerns need not immobilize your agency. Your hospice can thrive with proven strategies and the correct guidance if you consider your options.

How are you getting paid?

Financial concerns are nothing new in hospice care. Revenue management is now more important than ever. There are many factors that are needed to ensure accurate hospice revenue. Tracking of subsequent billing, tracking of Notice of Termination or Revocation (NOTR), Certificate of terminal Illness, ensuring timely changes in Level of Care as well as appropriately accounting for adjustments (Sequestration) as well as others.

In March of 2020, Centers for Medicare Services eliminated the sequestration adjustments for all claims with service dates from May 1, 2020 to December 31, 2020. It will be important to ensure your EMR and Fiscal intermediary is appropriately adjusting the claims to ensure accurate revenue recognition.

On another note, primary insurance companies are now offering hospice care into their coverage plans. Traditionally, hospice care has dealt with Medicare and Medicaid with very little interaction with private insurance. However, this sector is beginning to grow, and many providers are struggling with payment requirements for various insurance providers. Making sure providers are getting paid is a struggle when billing is done in one dominant fashion for decades. Without the proper background and knowledge to ensure billing is correct, providers may be left in the dust without payment. Ensuring appropriate setup in the EMR to produce accurate claims is a must.

Getting the right staff

Staffing is a weekly struggle for hospices. As more individuals in the baby boomer generation continue to age and require the need of hospice care, the staffing requirements of agencies also increases. The current situation around COVID-19 only exacerbates this situation. If you’re using contracted employees or hiring new staff, you need to get these individuals in the field and working immediately. Investing too much time in ensuring these workers have the necessary tools to do their job may not be the best use of your resources. Maxwell Healthcare Associates has developed remote training webinars and tools to ensure that we can assist agencies in properly training field staff on the point of care documentation as well as ensuring your agency policy and procedures are being followed.

Correct documentation

Documentation regulations are difficult to comply with as requirements change, and workloads increase. Paper-based processes are time-consuming and cumbersome. Home health and hospice providers have recognized this challenge and transitioned to electronic health records. However, not all technology is made equal. Many changes to documentation have come from the waivers applied to the COVID- 19 challenges. Ensuring that the appropriate items are captures in the virtual (Phone or screen share) visits has become a challenge. Undoing the changes and habits will be just as challenging. Adding validations and additional documentation post COVID-19 response will be needed.

Modern day concerns with hospice are difficult to navigate without the right guidance. The experts at Maxwell Healthcare Associates (MHA) are ready to review your current processes to identify areas of optimization. MHA offers efficient and effective solutions to address bottlenecks and redundancies in your organization as we solve regulatory, technological, operational and financial concerns. Reach out to us at info@maxwellhca.com to learn more.

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