PDGM
Will the number of therapy visits affect reimbursement?
What is it will not play a role under PDGM
What was the first state selected under the RCD and when was the start date?
What is Illinois and on 6/1/19.
Name the different levels of hospice care.
What is Routine Home Care, Continuous Home Care, Inpatient Respite Care, General Inpatient Care.
Are you required to enroll in Traditional Medicare in order to receive Medicare Advantage coverage?
What is No.
What year was BlackTree started?
July 2011
How many unique HHRG groups will exist under PDGM?
What is 432
Will LUPA claims will be selected as part of the RCD?
What is No
What happens to a patient's benefit period if they choose to transfer to another agency?
What is the benefit period will continue as normal
What time of year is open enrollment for Medicare Advantage plans?
What is January 1st.
What was the original name of the 'Deli on 4th' located in Conshohocken, PA?
What is Donny Mac's Deli.
Under PDGM, what is the updated split payment percentage for RAPS vs. Finals?
What is 20% for RAPs and 80% for finals
How long is the whole Review Choice Demonstration, across all states, projected to last?
5 years
Name the locations where Hospice services can be provided.
What is the home, hospice center, hospital, SNF
Name one of two states that have the highest percentage of Medicare beneficiaries enrolled in Medicare Advantage plans?
Minnesota or Florida!
What is Sutcliffe Park
What is a high comorbidity adjustment?
What is two or more secondary diagnosis that meet criteria.
Name the initial choices agencies can select for the RCD?
What is Pre-claim review (100%), Postpayment review (100%), Minimal review with 25% reduction
Based on the 2020 Final Rule, which Hospice levels of care are expected to experience a rate increase?
What is Continuous Care, General Inpatient Care, Respite Care
Which three insurance companies occupy the largest share of Medicare Advantage enrollees?
What is United Healthcare, Blue Cross, Humana
Outside of the Partners, who is the longest tenured BlackTree employee?
What is Erin Masterson
Name all five case-mix weight variables that exist under PDGM?
What is timing, admission source, clinical grouping, functional impairment, and comorbitiy adjustment
Scenario: You are a branch office in Colorado but your Parent Company is located in Texas. You operate under the same NPI, but in a non-demonstration state. Will you have to participate in RCD?
What is 'Yes'
The 2020 Final Rule is implementing a new hospice patient assessment tool called HOPE. What does HOPE stand for?
What is Hospice Outcomes & Patient Evaluation
The percentage of patients enrolled in Medicare Advantage has been increasing for the last 10+ years. In 2019, around what percent of Medicare beneficiaries were enrolled in Medicare Adv?
What is 34%
Can you name the top 5 revenue producing clients.
Unity Point, Elara, FHM, Traditions, JourneyCare