Home health agencies struggling with cash flow shortages after Medicare reduced its upfront payment to 20% this year could see increased financial problems in 2021 when the upfront payment is eliminated.

As reported in the McKnight’s Home Care Daily on Nov. 5, even though the payment part of the Request for Anticipated Payment, or RAP, goes away next year, failure to submit the necessary paperwork associated with those disappearing payments within a new 5-day window will result in new penalties.

Simply put: Successfully navigating RAPs in 2021 will require a new mindset for home health agencies, with faster turnaround times, prioritized oversight for timeliness, efficient electronic medical record processes and smart decisions about where to cut corners to save time. This is according to Robert V. Simione, CPA, director, finance consulting, at Simione Healthcare Consultants, who shared his views last week during an educational webinar.

Also speaking was J’non Griffin, president of Home Health Solutions, a Simione Coding Company, who stressed the importance of not rushing the clinical assessments, as new requirements do not require the Outcome and Assessment Information Set, or OASIS, to be completed before RAP submissions.

“Agencies still have five days for a collaborative assessment, and in 2021 the RAP can be submitted before the OASIS is completed,” Griffin said, adding that reimbursement considerations may be at stake. “An agency may miss a lot of opportunities under the Patient Driven Groupings Model by rushing the process.”