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3waysYour MDS Transmission Workflow IsHurting Reimbursement

IntroductionIs your MDS transmissionworkflow working againstyour reimbursementstrategy?You’ve done the hard work — residentinterviews, ADL flow sheets, EHR records,therapy notes the list goes on. Now all you3 Ways Your MDSTransmission Workflow IsHurting Reimbursement— especially one that includes more than16,000 long-term care facilities and 1.5 millionresidents.The good news is that the rules and regulationsThe flow of MDS data withinapply uniformly to all players. The bad news isthe facility is critical to successthat the system’s complexity makes compliancein managing reimbursement.a difficult task.have to do is transmit your MDS assessmentAnd to make matters worse, in order to bebatches to CMS.successful, skilled nursing facilities mustSimple, right? Not so fast.carefully manage their MDS workflow andtransmission in order to achieve optimalreimbursement levels.Many long-term care organizations don’t realizethat the flow of MDS data within the facility iscritical to success in managing reimbursement.Under the single umbrella known as MDS 3.0,CMS has created a complex system that aims tocover the full breadth of resident care, qualityHave you fully evaluated your MDS informationand transmission process and its impact onyour organization?measures and facility reimbursement acrossThis eBook lays out three key areas related tothe country. That’s a tall order for any systemMDS workflow and transmission that might behurting your reimbursement strategies.1

#1Manual MDS transmission slowsworkflow and compounds errorsAutomating data makessenseAn inefficient process fortransmissionA key area where a long-term care facility’sreimbursement may be affected by a manualprocess is in the transmission of MDS batchesInserting a manual transmissioninto the MDS workflowto CMS. In this scenario, the work relateddiminishes the value of bothIn a world where data is constantly flowing,to creating the MDS assessment has beenchanging and increasing in volume, it simplyhuman capital and IT systems.completed and only transmission remains.makes sense to automate. In fact, dataautomation has become such an integral part ofour lives that we’ve almost stopped noticing it.For example, email is an important part of yourprofessional life. But what if you had to stopwhat you were doing and manually sync yourcomputer to check for new messages? Whatif you were expecting an important text butWhat happens now? Automation stops andcouldn’t receive it until you manually instructedthe MDS staff has to physically manipulateyour phone to connect to your service provider?data files (which include protected healthThese scenarios seem ridiculous in today’sworld. Unfortunately, many data processes inlong-term care are still performed manually.And this can add up to a significant cost overtime.information), connect to the remote CMSservers via VPN, and manually transferassessment batches. Then there is usually aseparate but similar process to retrieve CASPERreports from CMS.2

#1 Manual MDS transmission slows workflow and compounds errorsThis is where the productivity of MDS staff andIncreased likelihood of errors. When staffthe usefulness of automated clinical systemstime is taken up by a cumbersome manualfalter. Inserting a manual process like this intoprocess, it becomes more likely that MDS errorsthe MDS workflow diminishes the value of bothand rejects will be overlooked. This becomeshuman capital and IT systems.magnified when there is frequent employeeturnover or limited staff training.How is reimbursementaffected?Magnification of inefficiencies. A manualprocess creates inefficiencies that can addup over time. As with any manual process,Reducing manual processeseliminates errors and allowsinformation to flow in a morecontrolled and measurable way.small errors become compounded, especiallyas workloads and regulatory requirementsincrease.A manual MDS transmission process canBenefits of automationnegatively affect reimbursement because itA manual data process is like walking onleads to:Less focus on areas of strategic value. Theinclusion of this manual process into the MDSworkflow leaves less time for staff to focuson MDS accuracy and efficiency. Their focus isdevoted to a time-consuming process ratherthan being directed to areas of strategic valuea treadmill. While you’re doing it, you’reaccomplishing something but can’t focus onother tasks. When you automate the process,you step off the treadmill and let it run byitself while you turn your attention to moreimportant areas — including those that directlyaffect the bottom line.to the facility.3

#1 Manual MDS transmission slows workflow and compounds errorsIn addition, all your CMS data — FinalValidations, CASPER reports and QI/QMdata — are retrieved automatically as part ofthe same process and displayed in a simpledashboard view, allowing MDS staff to easilytrack warnings, and correct issues and resubmitrejects in minutes.Reducing manual processes not only eliminateserrors, it allows information to flow in amore controlled and measurable way. Withautomation, staff can do more work moreeasily. Workflow improves across the facility,and reimbursement and profitability naturallyincrease.The solution: Automate CMStransmissionTHE TAKEAWAYAutomating MDStransmission minimizeserrors and allows staffto focus on areas ofstrategic value.This automated workflow creates a processthat is as near to real-time as possible, andeliminates errors that a manual processinevitably brings.The alternative to the cumbersome manualMDS process is an automated MDS transmissionworkflow. This means that as soon as yourclinical system creates an MDS batch, it isautomatically detected and submitted to CMSwithout any manual intervention.4

#2Lack of visibility means missedbilling opportunitiesA limited view of dataA big reason that long-term care facilities failIt’s no secret that analyzing and understandingthat they don’t have a complete picture of theirdata has become fundamental to success in anyMDS transmission workflow.to achieve optimal reimbursement, however, isindustry. In order to stay ahead of competitionWithout a complete picture ofMDS transmission workflow,and changing regulations, businesses must notonly have access to all their data, but be ableLTC facilities fail to achieveto view it in an understandable and actionableoptimal reimbursement.way.The key words here are understandableand actionable.Rather than seeing a top-level view of all MDStransmission activity, which ideally includes anend-to-end picture of the workflow down to theindividual MDS assessment and resident, MDSThis is one reason we hear so much aboutstaff are often limited to manually searching ondashboards these days. A dashboard providesa granular basis for MDS rejects and exceptions.a simple view of data and key performanceBecause they don’t have the power to see theindicators (KPIs) that relate to a particularbig picture, it’s easy to overlook errors and missbusiness objective or process. The goal is tobilling opportunities.highlight key information about the business sothat managers know where changes need to bemade.In addition, the limitations of accessingreports and data directly from CMS lead toeasily missing key indicators. The data may beavailable from CMS, but is often overlookedbecause of the difficulty in accessing it.5

#2 Lack of visibility means missed billing opportunitiesWhat about multiplefacilities?With a clear view of the data, regional andcorporate staff can easily analyze qualitymeasures across multiple facilities. Activitycan be viewed by batch or assessment and theresults filtered by facility or status, allowingquick diagnose and resolution of problems.Unfortunately, in regard to the traditional MDSworkflow, the manual process for managingMDS transmission means that organizationswith multiple facilities have a severelyrestricted view of their data. Limited to amanual process, business office managers andreimbursement specialists can’t see the bigpicture of their MDS workflow – which directlyThe ability to see data across the enterprisethat is both understandable and actionablemeans that MDS reimbursement can beaddressed as a targeted business strategy, notA clear view of MDS dataallows reimbursement tobe addressed as a targetedbusiness strategy, not just ashot in the dark.just a shot in the dark.How is reimbursementaffected?impacts facility reimbursement – much lesssee what that picture looks like across multiplefacilities in an organization.For long-term care organizations with multiplefacilities, the need for a management-level,actionable view of MDS transmission dataA limited view of MDS transmission workflowis clear. This is where the true power of ancan negatively affect reimbursement because itautomated MDS transmission managementleads to:dashboard comes into play. The dashboardview allows managers to see a clear pictureof reimbursement outcomes across the entireenterprise and shows them where action isrequired.Missed billing opportunities. A limited viewof data means that key indicators and billingopportunities are easily overlooked. Overtime, this can add up to a big impact on anorganization’s overall reimbursement.6

#2 Lack of visibility means missed billing opportunitiesCompounding of errors over time. The manualassessments were accepted, accepted withprocess of MDS transmission, coupled with awarnings or rejected. Staff can then instantlylack of insight into the data, means that errorsanalyze problem areas and correct errors withinin transmission and data analysis more easilyminutes.occur. This scenario only gets worse as theTHE TAKEAWAYvolume of data grows.Under-performing facilities. Without a toplevel view of the MDS transmission workflowCASPERacross multiple facilities, it’s impossible tocompare performance of individual facilitiesand staff members. Both accountability andreimbursement can suffer.The solution: Acomprehensive MDSdashboard viewTrying to understand MDS workflow via a singleTo quickly research rejected assessments,simply filter the assessment view to see onlyrejects. Your most recent assessment appearsTo truly optimizereimbursement andminimize MDS errors,facilities need a full360-degree view oftheir MDS processes.first and one click opens the Final Validationreport to the error message. Another click andyou can view the MDS as a PDF or in its nativeXML format and quickly assess the issue.manual transmission episode is like lookingIn addition, all your CMS and CASPERthrough a keyhole. A few things are visiblereports are accessible in one place. You canbut it’s far from a complete picture. To trulyview and print Initial Feedback and Finaloptimize reimbursement and minimize MDSValidation reports, as well as two years oferrors, facilities need a full 360-degree view ofMDS assessments, Initial Feedback and Finaltheir entire MDS process. What would this kindValidation reports. Items over two years old areof view look like?automatically archived for retrieval at any time.A 360-degree view of the MDS process includesan intuitive dashboard view of all your MDSactivity, allowing you instantly to see whether7