Metrics and KPIs

Mastering Hospice Online Reputation: A Practical Playbook for Home-Based Care

In the deeply personal world of hospice care, an agency’s digital presence is often the first, and most important, introduction a family has to the organization. A hospice agency must place significant focus on managing its online reputation. The Intimacy of In-Home Care For families considering hos

August 24, 2025 · 3 min read

Improving your Organization with FAST Goals

Goals have come to dominate our modern workplace. Goals are a way of breaking down business plans into smaller more manageable pieces. This enables an organization to accomplish some of the targets and plans that were specified during their planning cycle. Organizations set strategic goals, teams se

January 2, 2025 · 4 min read

Informative Podcasts from BRG

These interesting and informative podcasts from Berkeley Research Group, LLC were developed for nurse executives. Nurse Executive Podcast The podcasts cover a wide range of interesting and timely topics such as leadership, workplace violence, revenue capture, AI, use of technology, and how to best w

July 29, 2024 · 1 min read

Hospice Length of stay – active or discharged patients?

Patient length of stay is monitored to detect instances of inappropriate use of the hospice benefit or other deficiencies in the services delivered by the hospice provider. Length of stay is monitored for both very short length of stay as well as for length of stay that is longer than the norm. What

March 22, 2023 · 3 min read

Average length of stay versus median length of stay

Patients are eligible for hospice if they have a terminal diagnosis and a prognosis of six or fewer months to live if their disease runs its natural course.  A patient who lives longer than six months can still get hospice care if the medical director or other hospice physician recertifies that the

March 22, 2023 · 5 min read

Using data to support a hospice marketing strategy

Why is data valuable? Like all other business decisions, a hospice marketing plan must be data driven. More progressive hospice agencies have increasingly begun to understand the value of many types of data in supporting business decisions.   This includes internal data such as patient EMR data, fin

January 29, 2023 · 3 min read

What is a UPIC audit?

What is a UPIC? Unified Program Integrity Contractors (UPICs) are contracted by CMS to conduct detailed medical review, data analysis, and audits of healthcare providers to investigate possibilities of Medicare or Medicaid fraud, waste, and abuse. While the primary purpose of a RAC or MAC audit is t

January 28, 2023 · 8 min read

What is the TPE audit process?

What is a TPE? A Targeted Probe and Educate (TPE) is an audit program that was rolled out by CMS in 2017. The stated goal of this program is to help providers reduce claim denials and appeals. The TPE works to achieve its goal by educating providers in topics that will help to eliminate common [&hel

January 28, 2023 · 3 min read

What is a SMRC review?

What is a SMRC? A SMRC is a Supplemental Medical Review Contractor. CMS contracts with SMRCs to conduct medical reviews for Medicare Part A, Medicare Part B, and DME providers. SMRCs are contracted through the Center for Program Integrity/Provider Compliance Group Division of Medical Review and Educ

January 28, 2023 · 7 min read

What is Hospice Item Set (HIS)?

All Medicare certified hospice agencies must submit an HIS Admission and HIS Discharge record on all admissions and discharges from their agency. The report must include all patients, irrespective of payer source, patient age, or location where hospice services were provided. It is recommended that

November 27, 2022 · 3 min read

What is the CAHPS survey?

The CAHPS survey is intended to measure the experience of patients who had died while receiving hospice care and the experience of their primary caregivers.  It surveys informal caregivers – usually family members – of the persons who died under hospice care. The survey is a component of the Ho

November 27, 2022 · 5 min read

What is a hospice PEPPER report?

Program for Evaluating Payment Patterns Electronic Reports (PEPPER) is a data analysis report that has been available for hospices since 2012. This report contains claims data statistics based upon UB-04 claims data submissions for a single hospice agency. The statistics are generated for areas that

November 26, 2022 · 6 min read

Understanding the PEPPER Report

The PEPPER report target areas focus on statistics that will identify potential for improper Medicare billing. Comparison to national, jurisdictional, and state percentiles can highlight a hospice agency’s potential need for change to its practices to guard against improper billing. Hospice agencies

November 26, 2022 · 5 min read

What is Hospice Visits in the Last Days of Life (HVLDL)?

HVLDL is an HQRP claims-based measure of the proportion of patients who have received in-person visits from a registered nurse (RN) or a medical social worker (MSW) on at least two of the final three days of life. This metric replaces the HIS-based measure Hospice Visits When Death is Imminent (HVWD

November 13, 2022 · 4 min read

What is Hospice Care Index (HCI)?

HCI is a single comprehensive metric reflecting ten indicators of care delivered during a hospice stay — from admission to discharge.  This metric, which is included in the patient Care Compare portal, is intended to provide patients, families, and caregivers with an added metric to support inf

November 13, 2022 · 4 min read

Must every hospice participate in the CAHPS hospice survey?

What is the CAHPS hospice survey? The CAHPS hospice survey is administered to eligible caregivers after a patient’s death to measure the quality of care and communication provided by the hospice. A hospice agency must participate in the CAHPS Hospice Survey to be eligible for its full annual payment

November 7, 2022 · 3 min read

Selecting a CAHPS Hospice Survey Vendor

Why should a hospice agency use a CAHPS Hospice Survey vendor? A hospice agency is not permitted to administer its own CAHPS Hospice Surveys. Instead, every hospice agency is required to contract with an approved CAHPS Hospice Survey vendor. The vendor will administer the CAHPS Hospice Survey on an

November 7, 2022 · 3 min read

Hospice Acronym Alphabet Soup

Are you confused by the Acronym Alphabet Soup? Does the never ending list of acronyms used in the hospice and healthcare industry leave you confused? Are you worried that you may confuse CMN with CMP? To help sort out the confusion, we add here links to lists of acronyms: Acronyms commonly found on

September 15, 2022 · 1 min read

What is a MAC?

A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B medical claims for Fee For Service (FFS) beneficiaries. CMS relies on these contractors to serve as the primary operational contact betwee

September 12, 2022 · 2 min read

Accounts Receivable by Payer

Who are Hospice Agency Payers? A payer is the company of government agency that pays the provider, i.e., the hospice agency, for the medical service that is administered to the patient. For most hospice agencies, Medicare is the primary payer for hospice services. See, for example, this study publis

July 25, 2022 · 2 min read

Aging Accounts Receivable

What is Aging Accounts Receivable? The age of accounts receivable (AR) is the time that has elapsed from the time the agency delivered the service to the patient until current date. Aging AR is typically grouped into monthly buckets (e.g., 0-30 days, 31-60 days, etc.). Total dollar value of outstand

July 25, 2022 · 2 min read