MVI Empowerment Hour – CAP for Smart People!, with Troy Gehrke & Andrew Reed – VIDEO

Understand CAP → Manage CAP → Protect the Hospice.

Hospice CAP can feel complicated, but it becomes far less intimidating once you understand the MECHANICS. Troy Gerky breaks CAP down from the 30,000-foot view into the calculations that actually matter—how Medicare counts beneficiaries, why Streamlined and Fully Prorated CAP behave very differently, and how long-lived patients can create a nasty surprise YEARS after an apparently clean CAP submission. Andrew then joins the live Q&A to move from calculation into operational strategy: CAP should be MANAGED—not discovered after the fact.

The goal is not simply to stay miles below CAP. That can mean leaving reimbursement—and potentially valuable Hospice days—on the table. The professional objective is to understand your organization’s CAP position, monitor it throughout the year, protect against the unpredictable nature of patient longevity, and intelligently manage Length of Stay, Admissions, Documentation, reserves, and Quality. Know where you are. Know where you’re headed. And do not let CAP take your organization by surprise.

What you’ll learn:

• What Hospice CAP actually is, how Medicare establishes the annual limit, and why amounts above CAP become Medicare overpayments.
• The critical difference between Streamlined CAP and Fully Prorated CAP—and why Fully Prorated organizations can see prior-year CAP liability change as long-lived patients continue receiving care.
• Why rerunning prior-year PS&R reports can expose developing CAP liability BEFORE Medicare’s later recalculation catches you by surprise.
• Why MVI recommends monitoring Median Length of Stay based on LIVING patients, rather than relying on average Length of Stay or only terminated-patient measurements.
• How to establish an intelligent Length-of-Stay target, incorporate a reasonable “screw-up factor,” and manage close enough to CAP without recklessly running over it.
• What operational moves may help when CAP is getting HOT—including increasing appropriate Admissions, evaluating continued Hospice eligibility, strengthening Documentation, and understanding the impact of short- and long-lived patients.
• Why Perfect Documentation creates clinician Confidence, supports appropriate longer Lengths of Stay, and helps Hospices avoid becoming merely “brink-of-death care.”
• Why strong economics and adequate reserves matter: a CAP repayment should never be allowed to become an existential threat to an otherwise extraordinary Hospice.

Who is this for?
Hospice CEOs, CFOs, Finance Leaders, billing teams, compliance professionals, Clinical Leaders, and anyone responsible for CAP calculation, Length of Stay, Admissions, or protecting the organization’s financial future.

Featuring:
Troy Gerky and Andrew Reed

Resources mentioned:
PS&R Reports • MVI CAP Management Tool • MVI Management Application • CAP Monitoring Spreadsheet • MVI Benchmarking • Median Length-of-Stay Analysis • Perfect Documentation • System7

If you’re ready to stop treating CAP like an annual surprise and start MANAGING it like a Hospice professional, MVI can help.