In the News

President's Message

Posted: November 15, 2022

Recently, an APTA member brought to my attention that a large health system eliminated all of its home health rehab management staff, stating that “industry standard” dictated this change, and that they were “no longer qualified” to hold management positions. As President of APTA Home Health, I couldn’t disagree with this more! Our members, and physical therapists in general, are well qualified to lead in many practice arenas. I know of several Academy members who are successful agency owners and agency leaders! Furthermore, it is well within our scope of practice and education to lead others. In this reimbursement environment, I feel that it is key that rehabilitation professionals are led by other rehabilitation professionals who understand and have experience with the detailed clinical and documentation requirements of rehabilitation in home health. Quite simply, most nurse managers and business professionals don’t have a deep enough understanding of these requirements.

I challenge each of you, and your agencies and employers, to promote physical therapists as leaders and managers. It is vital to the success of our profession, and it is vital to the success of our employers!

Sincerely,

Phil Goldsmith
President
APTA Home Health

 

2023 APTA Home Health Award Nominations

The APTA Home Health Awards are presented annually to deserving individuals, recognized by peers and colleagues, at the Home Health Business Meeting during APTA's annual Combined Sections Meeting in February.

The Academy is now accepting nominations for the following awards through December 16, 2022. Please take a moment and consider an impactful individual to the home health practice worthy of recognition. 

  • President’s Award: Recognizes a Home Health Academy member who has provided notable service to the Academy.

  • Emerging Leader in APTA Home Health: Recognizes and honors one Physical Therapist or Physical Therapist Assistant who has demonstrated extraordinary service and clinical passion early in his or her home health career. The individual should have made exceptional overall accomplishments and contributions to the APTA and/or the Home Health Academy mission and vision, and to the physical therapy profession to advance quality and evidenced‐based care in the home.

  • Excellence in Home Health Clinical Practice Award: Recognizes a physical therapist or physical therapist assistant for outstanding clinical practice in a home health care setting.

  • Excellence in Home Health Leadership Award: Recognizes the exceptional contribution of an APTA Home Health member in promoting home health physical therapy practice.

  • Dr. Carol Zehnacker Friend of the Academy Award: Acknowledges an individual, group or organization that has made an enduring contribution to the home health industry and that has been an advocate of the profession of physical therapy in the home, as is relates to clinical practice and/or regulations. This award is dedicated to the late Dr. Carol Zehnacker who passed away in November 2021. Dr. Zehnacker was a physical therapist and a member of the APTA for 56 years. She served our profession in many ways at both the state and national levels as a leader, mentor, and advocate. She served as the Federal Affairs Liaison and Government Affairs Committee Chair for the Home Health Academy. In this role she advocated fiercely against administrative burden and regulations that hamper PTs ability to provide quality care. 

  • Preceptor Award: Acknowledges an individual that has been chosen by their agency/company to be a preceptor. This therapist demonstrates the unique qualities, high standards and clinical skills that are exemplary. They are organized and able to teach processes and procedures to newly hired staff, molding them into confident and talented home care clinicians.

To view awards criteria and to submit a nomination, click here

 

Dissecting the 2023 Home Health Final Rule: Several Articles to Help

The following articles help to bring additional perspective to the home health final rule and bring attention to things to look out for besides the pending rate cuts. Also see the downloadable resources included at the end of this section. 

NAHC President: CMS Was Tactical, Strategic In How Final Rule Was Announced
Home Health Care News | By Patrick Filbin

By walking back severe cuts initially proposed in the home health payment rule, the U.S. Centers for Medicare & Medicaid Services (CMS) was strategically trying to create positive feelings about the final rule in order to have an upper hand down the line.

That is the assessment made by William A. Dombi, president of the National Association for Home Care & Hospice (NAHC), less than a week removed the final rule’s publishing.

“It’s important to understand some of the politics of what happened in this final rule,” Dombi said during a NAHC webinar Friday. “CMS went with a headline saying they were cutting over $800 million — in one year alone — from home health care spending to a headline that now says they’re increasing spending by $125 billion. That was a strategic, tactical move by CMS to put out a positive headline.”

That messaging, Dombi said, has helped CMS initially convince Congress that lawmakers may not have to make any additional changes.

Read Full Article

From HHVBP to LUPAs: Additional Takeaways From The 2023 Home Health Final Rule
Home Health Care News | By Patrick Filbin

Following the Centers for Medicare & Medicaid Services’ (CMS) release of the final payment rule, it is critical for each home health agency to figure out its own financial standing and strategic plan for 2023. 

In addition, agencies should be finding key areas for improvement and educating clinicians on the recalibrated case-mix weights and Low-Utilization Payment Adjustment (LUPA) thresholds.

Those suggestions came during a Thursday webinar with experts with the home health consulting firm SimiTree.

“Each agency is going to be different in terms of what the financial impacts are going to be,” Nick Seabrook, managing principal at SimiTree, said. “The LUPA threshold going down is going to be a pretty significant change to agencies and that could move the needle pretty significantly from a revenue standpoint as well. It’s important to know what the impact of this is for your agency.”

Read Full Article

What Home Health Providers May Change Due To Final Rule
Home Health Care News | By Andrew Donlan

Now that the final payment rule for the home health care industry is officially out, providers and advocates will take the long-awaited next step.

For advocates, that will mean continuing legislation efforts. Although the final rule includes a 0.7% aggregate payment bump for home health agencies, behavioral adjustment cuts are still being implemented. That’s a phased-in approach that the Centers for Medicare & Medicaid Services (CMS) would like to continue in coming years. 

“We now turn to Congress to correct what CMS has done and prevent the impending harm to the 3.2 million highly vulnerable home health patients that depend on this essential Medicare benefit annually,” National Association for Home Care & Hospice (NAHC) President William A. Dombi said in a statement shared with Home Health Care News Monday. “Even with the limited phase-in of the rate cut, with significantly rising costs for staff, transportation, and more, home health agencies across the country cannot withstand the impact of rate cuts.”...

...There will still be margin pressures due to the final rule – and final rules for future years – if the Preserving Access to Home Health Act does not gain any more traction in Washington, D.C. That piece of legislation would curb any cuts to home health reimbursement until 2026.

And if the margins are not there, less investment in other service lines is almost a certainty. But what may actually tick up is investment in technology in order to increase efficiency in certain areas.

Read Full Article

RESOURCES

HH Final Rule 7.85% Rate Cut: Advocacy 1-Pager

HH Final Rule Federal Health Policy Strategies Analysis

 

Calendar Year (CY) 2023 Medicare Physician Fee Schedule Released

The Centers for Medicare & Medicaid Services (CMS) has finalized changes in CMS’s annual Physician Fee Schedule (PFS) proposed rule to significantly expand access to behavioral health services and moves the health system closer to achieving equitable outcomes through high quality, affordable, person-centered care. These changes will ensure CMS continues to deliver on our goals of advancing health equity, driving accountable care, and protecting the sustainability of the Medicare program.

Building on the CMS Innovation Center’s successful ACO Investment Model (AIM), CMS is changing the Medicare Shared Savings Program to make more Accountable Care Organizations (ACOs) available in rural and underserved areas, which builds upon our continuing efforts to advance health equity. We are launching a payment adjustment for ACOs that reward them when they provide excellent care to underserved populations.

The Innovation Center also sought comment on an alternative approach to calculating ACO historical benchmarks that would use administratively set benchmarks that are decoupled from ongoing observed FFS spending including the design of the approach, as described in the Request for Information (RFI). CMS has observed that the benchmarking methodology for the Shared Savings Program and Innovation Center models may include ratchet effects that reduce benchmarks for successful ACOs and jeopardize their continued participation over multiple agreement periods, resulting in selective participation (including limited participation by inefficient ACOs). The RFI gathered information regarding the future use of administrative benchmarking, and comments will be considered for future rulemaking.

For more information, please see the PFS press release.

 

Where to Start? Foundational Learning Materials for the Expanded HHVBP Model

Leading up to CY 2023, the HHVBP TA Team will spotlight different introductory resources to guide HHAs in preparing for the first performance year of the expanded HHVBP Model. CMS and the TA Team encourage HHA staff to review the following resources available on the Expanded HHVBP Model webpage:

  • HHVBP Model Expansion 101 Live Event – In February 2022, the HHVBP TA Team hosted a live learning event: HHVBP Model Expansion 101. The team shared essential information regarding the expanded HHVBP Model, including topics such as participation criteria, cohort assignment, quality measures, payment adjustment methodology, and performance feedback reports. The learning event concluded with a live Q&A session.
  • Expanded HHVBP Model Frequently Asked Questions (FAQs) – Routinely updated, the FAQs assist HHAs in understanding common terms used in the expanded HHVBP Model and requirements under the CY 2022 Home Health Prospective Payment System (HH PPS) final rule. The HHVBP TA team provides updates to the FAQs as needed and notifies HHAs that have signed up to receive communications when an updated version is available on the Expanded HHVBP Model webpage.
  • Expanded HHVBP Model Guide – The Model Guide includes an overview of the expanded Model, information on eligibility and cohorts, quality measures used in the expanded Model, Total Performance Score (TPS) methodology and payment adjustment methodologies, and an overview of the performance feedback reports.

If you have questions about implementation of the expanded HHVBP Model, please email the HHVBP Help Desk at [email protected]com

 
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