When the Centers for Medicare and Medicaid (CMS) implemented the no-pay Request for Anticipated Payment (RAP) policy on January 1, 2021, some home health providers were more prepared than others for the operational and financial impacts to their business. Many providers who average 12 to 15 days to file will now realize a substantial penalty of up to 40% of their reimbursement. Compounding that loss, those who don’t also efficiently manage their orders and protect their cash flow on the back end will not likely survive this new regulatory environment.
It can’t be overstated: the stakes with zero-pay RAPs are formidable.
As Beth Prince, vice president of revenue management services at Corridor explains in our recent webinar, significant CMS initiatives are always “stair-stepped,” and this is no exception. Beth points to how CMS moved to a lower, 80/20 payment split between RAP and Final in 2020, and in 2021 to no payment and timely filing requirements with penalties. She reminds home healthcare providers to plan (now!) for 2022, with the new Notice of Admission requirement.
Beth gives a broader context for these stair-stepped changes: CMS is embracing the "Triple Aim,” a care delivery design promoted by the Institute for Healthcare Improvement, which includes improving the patient experience, improving the health of populations, and decreasing the per-capita cost of care. Beth sees zero-pay RAPs as CMS moving the home health industry closer to a more standard payment structure relative to the larger healthcare industry, and ultimately, to value-based care delivery.
While the ‘why’ is laudable, operating in this new reality can be daunting. Whether your current RAP filing time averages four days or 24, this daily planner will give your operational and clinical teams clear, actionable guidance and concrete steps to hit your filing targets, improve your cash flows – and become penalty proof!
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As Forcura's Director of Communications and Brand Strategy, Kate brings a robust background and knowledge of the healthcare and post-acute industry to Forcura. She also represents Forcura as a social media ambassador at events around the country, is an on-camera reporter and interviewer, and host of our Innovate Jax podcast. |
