Simione™ Healthcare Consultants

It’s Cost Report Season! Are You Documenting the Right Expenses?

If you don’t document and report the demands on your business operations, it will always be harder to convince the boss that you need more resources to grow in changing times. This dynamic is in motion with the Centers for Medicare and Medicaid Services (CMS) when home health and hospice organizations submit their required annual cost report, and why financial and regulatory expertise are essential to getting it right.

“Everything reported in the cost report is the basis for evaluating and revising standards and ultimately, setting reimbursement, at CMS,” says Michael Simione, MBA, Director, Simione Healthcare Consultants. “The cost report is so much more than a CMS requirement. It is an opportunity to shed light on the realities of providing home health and hospice care, so that future rulings and rates reflect the true nature of industry need.”

Simione explains that the cost report tells a critical story on home health and hospice finance, generating a picture for CMS of what agencies need to deliver care, while providing agencies with a management tool for driving clinical and financial performance.   

Medical Supply Charges Matter

This year, medical supply charges remain an important factor in home health finance even though they do not impact payment under PDGM. Simione cautions agencies who may be omitting medical supply charges on their Medicare claims, because they directly affect future rebasing and determination of case mix weights (factoring in both average visit utilization and medical supply charges from the claim) as part of the home health Medicare cost report.

“With changing regulations and quite frankly, too many operational priorities that need attention, agencies may not document and report all of the information that will ultimately impact them in the form of future rebasing and regulations that change the way they do business,” Simione says.

Take Time to Document Telehealth

The same holds true for telehealth in home health and hospice, ever since virtual visits became a critical need during pandemic response. While telehealth involves a virtual visit to provide care and is newer to the scene, telemonitoring has been used for some time to monitor patients at home.  

Documentation of telehealth services has been critical since 2019, when CMS ruled to permit HHAs to include telehealth-related expenses in the cost report.  Then in 2020, legislators introduced the Home Health Emergency Access to Telehealth (HEAT) Act, which is currently under committee review in both Congress and the Senate.  While timing of the outcome is uncertain, Simione recommends that agencies be diligent about tracking these expenses.  “Agencies who break out their telehealth costs and expenses will be better prepared to demonstrate value and support future reimbursement, as well as document any relevant activity related to COVID-19 expenses,” he says. 

Go with a Leader in Cost Reporting

Simione Healthcare Consultants is largest preparer of cost reports in the industry. Backed by a comprehensive finance and data analytics team, we deliver timely, accurate reporting and a level of service that has set the industry standard for comprehensive support and filing to CMS. 

“We are striving to ensure our clients experience an expert process that can help improve agency management and decision-making as part of data-driven operations,” Simione says.

Call 800-949-0388 for a free quote to help ensure your agency’s cost report is accurate, timely and supports the future of home health and hospice finance.


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