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Risk Profile Analysis

Risk Profile Analysis. Provided by OCS Education E-learning Network “Confidential – For OCS Client Use Only”. Articulate Presenter -Control Features. Objectives. Demonstrate how to interpret the Risk Profile Analysis Reports List the steps to review for the Risk Profile Analysis reports

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Risk Profile Analysis

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  1. Risk Profile Analysis Provided by OCS Education E-learning Network “Confidential – For OCS Client Use Only”

  2. Articulate Presenter-Control Features

  3. Objectives • Demonstrate how to interpret the Risk Profile Analysis Reports • List the steps to review for the Risk Profile Analysis reports • Describe the overall benefit to your organization in determining your risk

  4. Data Transfer • What files are required? • OASIS and EDI Billing files • How often? • The files are transferred to OCS monthly • When are the reports posted? • By the 15th of the month

  5. Access to Risk Profile Analysis • Prerequisite: Getting Started with OCS • Log into Connection • Go to Report Folios tab • Access Risk Profile Analysis

  6. Risk Profile Report • Risk Profile Analysis • Provides insight intoregulatory and compliance issues • Result of Fraud Enforcement and Recovery Act, May 2009.

  7. Why use this report? Expect increased scrutiny and survey • Recovery Audit Contractors (RAC’s) • HEAT Enforcement • OIG-Office of Inspector General

  8. Compliance Plans • Compliance as part of the culture • Compliance is discussed and addressed • Systems to help report and identify problems • Formal Compliance • Written guidelines & plan tailored to your agency • On-Going Improvement

  9. Getting started • Step by step report review process

  10. Risk Profile Analysis • See where you stand • Dig into the details • Keep tabs on changes • Manage what matters most

  11. RPA Reports • Summary Update - Quarterly • Compliance Metrics – Year-in-Review • Quarterly Trends • Agency Risk Assessment

  12. See where you stand • Understand key areas: • PPS Metrics • HHRG Components • Therapy Metrics • Quality Measures • Do you standoutfrom the crowd? • Will your data raise eyebrows?

  13. Dig into the details • How does your number relate to national and regional performance metrics? • From both the patient (averages) and provider (medians)perspective • What do you find when you dig deeper?

  14. Keep tabs on changes • Where is your performancegoing? • Visualize variation • Understand changes • See the impact of your work • Is your path headingthe right direction?

  15. Manage what matters most • With limited time, and multiple locations, what is yourpriority? • ARA Index • Ranking system to highlight the locations with the highest risk • Who is your problem child?

  16. Report Review Process Step One:Summary Update (one page) Step Two: Compliance Metrics Year-In-Review (3 pages) Step Three: Quarterly Trends Step Four: Study your results Step Five: Determine your priorities Step Six: Investigate and take appropriate action!

  17. Are you ready?

  18. Connection Reference Guide • The Connection Reference Guide • http://marketing.ocsys.com/e-learning.asp

  19. Resources • OCS Client Services • 866.641.TECH (8324) • Email tech@ocsys.com • Live Chat • OCS e-Learning Network • http://marketing.ocsys.com/e-learning.asp • Recorded trainings • Group WebEx Presentations • Roadmaps & Tools • Report Interpretation Guide • OCS eDGE (electronic Discussion Group & Education) • http://ocsedge.activeboard.com

  20. Training Survey Link

  21. For More Information

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