Consistent with its annual update cycle every July, the most recent version of the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for home health was released last month and is currently available for download from the PEPPER Resources Portal. To get your hands on the HHA PEPPER, follow these steps:
- Familiarize yourself with the instructions provided in the Portal Access Instructions, which detail how to access the HHA PEPPER according to the Distribution Schedule.
- Navigate to the PEPPER Resources Portal.
- Fill in all the required fields.
- Proceed to download your PEPPER.
What is the PEPPER?
PEPPER compiles a comprehensive data set derived exclusively from your 30-day final claims. It remains unaffected by your cost reports, care plans, or OASIS data. The data gathered in PEPPER is then harnessed to calculate targets, which are subsequently pitted against the 80th percentile benchmarks of the nation, your Medicare MACs jurisdiction, and your state. Should your target calculations happen to exceed the 80th percentile national benchmark, there’s a chance your data might raise a flag for potential additional medical scrutiny.
Reviewing PEPPER for Compliance
Many home health agencies have received increased medical scrutiny based on data within PEPPER. It is important to review PEPPER findings with your compliance and quality assurance (QA) team in order to identify areas for improvement. Specifically, pay more attention to targets exceeding the 70th percentile and check if any data would also be relevant to your value-based purchasing claims-based measure scores. By proactively taking measures to steer clear of reaching the 80th percentile threshold in forthcoming calculations, you can effectively uphold your compliance standards and prevent additional medical scrutiny.