VISN_Kickoff v3 - National Association of State Veterans Homes

Report
State Home Per Diem (SHPD)
National Association State Veteran Home (NASVH) Summer Conference
July 27-August 2, 2014
SHPD Dictionary
ADHC
BMS
CBO
CBOPC
DOM
HIPAA
IPERIA
OMB
NASVH
NHC
PDF
PII
Adult Day Health Care
Business System Management
Chief Business Office
Chief Business Office Purchased Care
Domiciliary
Health Insurance Portability and
Accountability Act
Improper Payments Elimination and
Recovery Improvement Act
Office of Management and Budget
National Association of State
Veterans Home
Nursing Home Care
Portable Document Format
Personally Identification Information
VETERANS HEALTH ADMINISTRATION
PKI
SHPD
SME
SVH
VA
VAMC
VISN
10-10EZ
10-10EZR
10-10SH
Public Key Infrastructure
State Home Per Diem Program
Subject Matter Expert
State Veteran Home
Veterans Affairs
Veterans Affairs Medical Center
Veterans Integrated Service Network
Application for Health Benefits
Health Benefits Renewal Application
State Home Program Application for
Veteran Care Medical Certificate
2
PUBLIC LAW 112–248
JAN. 10, 2013
IMPROPER PAYMENTS ELIMINATION AND
RECOVERY IMPROVEMENT ACT (IPERIA) OF 2012
Presenter: Colette Alvarez
July 28, 2014
FY2014 IPERIA
• FY2014 Results have been released
o SHPD rate 3.02% (Goal 1.5%)
• Duplicate Payments
• 10-10EZs were missing or not signed
• 10-10SHs were missing or not signed
• Inaccurate tracking in tracking tool
– Incorrect per diem rates being used
– Incorrect bed hold methodology
– Incorrect leave methodology
VETERANS HEALTH ADMINISTRATION
4
10-10SH Automation
VISN 12 Pilot
Presenter: Colette Alvarez
Purpose of Pilot
•
Provide the capacity for the SHPD Program to design, launch, support and
evaluate automated 10-10 SH pilot between VISN 12 Great Lakes/VAMC and
SVH (Marquette) with support of CBOPC and CBO Systems Management.
•
The VISN 12 pilot will serve as Phase I and the remaining facilities will
serve as Phase II, based on the outcomes and recommendations from the
Phase I pilot.
•
When implemented nationwide, it will improve program efficiency and
significantly reduce improper payments.
•
Required to use current 10-10SH form (May 2009) until OMB approves new
form with improved clarification and functionalities.
VETERANS HEALTH ADMINISTRATION
6
Goals of Phase I
•
•
•
•
•
•
Convert the current 10-10SH PDF form into a web-based, fillable form
that can be electronically submitted to VHA State Home Per Diem Care
Program.
Include validation on the form that precludes the 10-10SH from being
submitted electronically unless all of the required fields/information
have information in them.
Require an electronic signature or equivalent prior to submission.
Provide a date/time stamp upon receipt at the VA facility to assist with
the 10 day rule determination.
Determine if the 10-10SH should be paired with a 10-10EZ for initial
admission to a State Veterans Home (SVH) and for per diem payments
for domiciliaries.
The VA portion of the application should allow the VA representative to
return incomplete applications to the SVH along with a notification to
them and record the receipt of a “completed” application.
VETERANS HEALTH ADMINISTRATION
7
10-10SH Pilot Screen Snapshot
VETERANS HEALTH ADMINISTRATION
8
10-10SH Pilot Screen Snapshot
The automated 10-10SH is made
up of a series of panels devoted to
specific areas of the 10-10SH form.
Filling out the panels populates the
actual form. It also makes it
possible to populate multiple fields
from one entry.
The panels are divided between
the two sections of the form. There
is one set for the SVH, one for
purchased care, and another for
the clinical reviewer.
The fields on the panels are also
tied to the business rules for SVH.
VETERANS HEALTH ADMINISTRATION
9
Where We Are Today
• Guided version of the 10-10SH completed and vetted
within VA
• SVH and VA pilot sites selected and contacted
• SVH personnel obtained PKI and have secure email
• VA site setting up email account for receipt of SVH
submissions
• Training package for both groups ready
• Practice data selected and formatted
• Dates for pilot being coordinated among participants
• Incorporate lessons learned and feedback from the SVH
and VAMC into the form
VETERANS HEALTH ADMINISTRATION
10
VISN 12 PILOT CONTACTS
• Colette Alvarez, VA Program Manager,
State Home Per Diem Program (SHPD)
[email protected]
(775) 326-5721
• Brad Radichel, VA Project Manager
[email protected]
(404) 828-5622
• Brenda Wiggins, VA Project Manager/COR
[email protected]
(202) 382-2529
VETERANS HEALTH ADMINISTRATION
11
Organization Pilot
Improving Veterans
Access to Care
CBOPC State Home Per Diem Program (SHPD) Pilot
Presented to: National Association of State Veterans Home Administrators
Presenter: Jeanne Crook
July 28, 2014
Why an Organizational
and Process Pilot?
• Gathered and reviewed data
• Determined training alone would not
solve root cause
• Based on Interviews and feedback from
SME’s in the field
VETERANS HEALTH ADMINISTRATION
13
Overall Benefits
What SVH Will See
Resulting In …
• Dedicated Staff
• Standardized forms
• Reduced length of time
for application and
invoice approvals
• Consistent processes
and procedures
• Improved visibility and
communications
• Clear escalation path
• Decreased requests to
you for redundant
documentation
VETERANS HEALTH ADMINISTRATION
14
Next Steps
• Hire and Train Lead Contact Representative
and 2-Contact Representatives
• Implement requirements for State Veterans
Homes Access
• Develop Metrics and Analysis for the Pilot
• October 1st Launch
• Continue Monthly Briefings with NASVH
Leadership
VETERANS HEALTH ADMINISTRATION
15
VISN 19 PILOT CONTACTS
• Colette Alvarez, VA Program Manager,
State Home Per Diem Program (SHPD)
[email protected]
(775) 326-5721
• Andre’ Bynum, VA Project Manager/COR
[email protected]
(303) 372-4659
• Martin Ottenbrite, Pilot Project Manager
[email protected]
(720) 470-4025
VETERANS HEALTH ADMINISTRATION
16
2015 Per Diem Rates
Presenter: Jeanne Crook
July 28, 2014
FY2015 Basic Rates
• 2015 Per Diem Rates will increase by 2% for the following:
– ADHC $81.56
– DOM $44.19
– NHC Basic $102.38
• Source of the increase is the Center for Medicare and
Medicaid Services’ for Skilled Nursing Facilities for FY 2015,
as printed in the 5/6/2014 Federal Register.
VETERANS HEALTH ADMINISTRATION
18
State Home Per Diem Program
Contacts
Colette Alvarez
State Home Per Diem Program Manager
[email protected]
(775) 842-2529 or (775) 326-5721
Brenda Wiggins
Program Analyst
[email protected]
(202) 382-2529
Gloria J. Sanford
Deputy Program Manager
[email protected]
(303) 331-7856
Andre’ Bynum
Program Analyst/COR
[email protected]
(303) 372-4659
Jeanne Crook
Program Specialist
[email protected]
(303) 398-5224
Gloria Testa
Budget Analyst
[email protected]
(303) 398-5573
Vacant/New Hire
Lead Contact EEV Representative
(Projected August 2014)
Stephanie Haddock
Program Specialist
[email protected]
(303) 331-7504
Isabel Saunders
Program Specialist
[email protected]
(303) 372-6209
Vacant/New Hire
Contact EEV Representative
(Projected August 2014)
Stephen Pellicer
Program Specialist
[email protected]
(386) 623-5534
Monica Scott-Carter
Administrative Specialist
Monica [email protected]
(303) 780-4733
Vacant/New Hire
Contact EEV Representative
(Projected August 2014)
VETERANS HEALTH ADMINISTRATION
19
State Home Per Diem VISN Liaisons
SHPD Staff
Andre’ Bynum [email protected]
Jeanne Crook [email protected]
Stephanie
Haddock [email protected]
Steve Pellicer [email protected]
Gloria Sanford [email protected]
Isabel Saunders [email protected]
Gloria Testa [email protected]
Brenda Wiggins [email protected]
VETERANS HEALTH ADMINISTRATION
VISNs Assigned
19
1, 22, & 23
6, 9, 18, & 20
7, 8, & 15
3 & 10
4, 5, 16, & 21
2, 11, & 17
12
20
QUESTIONS
VETERANS HEALTH ADMINISTRATION
21
THANK YOU!
VETERANS HEALTH ADMINISTRATION
22

similar documents