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  Describe the overall benefit to your organization in determining your risk

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 15 th of the month

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

Risk Profile Report  Risk Profile Analysis Provides insight into regulatory and compliance issues Result of Fraud Enforcement and Recovery Act, May 2009.

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

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

Getting started  Step by step report review process

Risk Profile Analysis 1.See where you stand 2.Dig into the details 3.Keep tabs on changes 4.Manage what matters most

RPA Reports 1.Summary Update - Quarterly 2.Compliance Metrics – Year-in-Review 3.Quarterly Trends 4.Agency Risk Assessment

See where you stand  Understand key areas: PPS Metrics HHRG Components Therapy Metrics Quality Measures  Do you stand out from the crowd?  Will your data raise eyebrows?

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?

Keep tabs on changes  Where is your performance going?  Visualize variation Understand changes See the impact of your work  Is your path heading the right direction?

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

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 t ake appropriate action!

Are you ready?

Connection Reference Guide  The Connection Reference Guide

Resources  OCS Client Services TECH (8324) Live Chat  OCS e-Learning Network Recorded trainings Group WebEx Presentations Roadmaps & Tools Report Interpretation Guide  OCS eDGE (electronic Discussion Group & Education)

Training Survey Link

OCS Education Sue Blockberger-Miller MSN, RN OCS Director of Education Leslie Knudsen-Wells, RN BS Performance Improvement Educator For More Information