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Prevent Cuts to Home Health: Ask Your Members of Congress to Support the Preserving Access to Home Health Act (S. 2137)

 

Webinar: Expert How To's Not CEUs for Professional Development

When: Wednesday, August 16, 2023 | 8:30pm - 10:00pm ET

This webinar will cover the importance of professional development planning for prevention of burnout and career advancement.

Learning Objectives:

  1. Following this session, the learner will be able to define and identify the differences between professional development planning, mentoring, coaching, training and the benefits of each.
  2.  Following this session, the learner will be able to craft an effective professional development plan.
  3. Following this session, the learner will be able to explain their own specific professional vision, goals, and immediate needs.
  4. Following this session, the learner will understand strategies to reduce burnout through prioritizing life-work flow through the use of professional development planning as a framework.

This webinar will count for 1 Hour of CEU. 

Click here for more information and to register. 

 

Bipartisan House Lawmakers Introduce Preserving Access to Home Health Act to Protect Patients from Harmful Home Health Program Cuts

PQHH-NAHC Press Statement
 
New report underscores need for policies to ensure timely patient transition to home health following hospitalization 
 
Washington, D.C. – The Partnership for Quality Home Healthcare (PQHH) and the National Association for Home Care & Hospice (NAHC) today commended Representatives Terri Sewell (AL-7) and Adrian Smith (NE-3) for introducing the Preserving Access to Home Health Act of 2023 in the U.S. House of Representatives. If enacted, the bill would safeguard access to essential, home-based, clinically advanced healthcare services by preventing the Centers for Medicare & Medicaid Services (CMS) from implementing cuts as high as $20 billion over the next decade.
 
“The Medicare home health community strongly supports this legislation and thanks Representatives Sewell and Smith for their leadership on a Medicare issue that truly threatens access to care for the more than 3 million beneficiaries who rely on this care,” said William A. Dombi, President of the National Association for Home Care & Hospice. “The home health community calls on Congress to ensure the stability that patients and providers urgently need. Since Medicare has again proposed deep cuts to home health in 2024, Congress must act to protect the care their constituents prefer and want.”
 
Specifically, the bill is designed to address cuts made to home health by CMS during the implementation of Medicare’s Patient Driven Groupings Model (PDGM) by making the following policy changes:

  1. Repealing permanent and temporary Medicare payment adjustments. The bill would repeal the requirement that CMS make determinations related to the impact of behavior changes on estimated aggregate expenditures. The legislation would eliminate CMS’s authority to adjust home health payments based on such determinations under PDGM. This change would take effect, and be implemented, as if it were included in the Bipartisan Budget Act of 2018, which included home health provisions that led to PDGM implementation.
  2. Instructing MedPAC to analyze the Medicare Home Health Program. The bill instructs MedPAC to review and report on aggregate trends under Medicare Advantage, Medicaid, and other payers and consider the impact of all payers on access to care for Medicare home health beneficiaries. To verify MedPAC’s calculations, the Commission would be required to make its calculations public. This provision would also add requirements for Medicare home health cost reports to include data on visit utilization and total payments by program.

Read Full Article

 

CMS Unveils Dementia-Focused Payment Model with Interdisciplinary Care Approach

Hospice News | By Jim Parker

The U.S. Centers for Medicare & Medicaid Services (CMS) has unveiled a new payment model demonstration geared toward dementia-related illnesses, which are becoming more prevalent among hospice patients.

The Guiding an Improved Dementia Experience (GUIDE) Model is designed to improve the quality of life for dementia patients and their caregivers by addressing behavioral health and functional needs, as well as better coordinating care and improving care transitions between community, hospital and post-acute settings.

“While we have made tremendous progress in improving care for people with dementia through the National Plan to Address Alzheimer’s Disease, people living with dementia and their caregivers too often struggle to manage their health care and connect with key supports that can allow them to remain in their homes and communities,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “Fragmented care contributes to the mental and physical health strain of caring for someone with dementia, as well as the substantial financial burden.”

Participating patients and families will also have access to a care navigator to help them access clinical and non-medical services.

Patients will be stratified into one of five tiers, based on a combination of their disease stage and caregiver status. Care intensity and payment increase by tier, according to CMS.

Reimbursement through the model includes a per-member, per-month payment, as well as an infrastructure payment for some safety net providers. Participating operators may also receive payment for respite care.

Patients who have elected the Medicare Hospice Benefit are not eligible for the program. However, hospice and palliative care providers that offer upstream services may be uniquely suited to implement such a model, either directly or through a partnership.

GUIDE involves a trained interdisciplinary care team that delivers a standardized set of services based on a person-centered care plan, according to CMS.

Read Full Article

GUIDE Webinar

CMS will host a webinar to provide more information on the GUIDE Model. During the session, the GUIDE team will discuss the goals of the model, participant and beneficiary eligibility criteria, care delivery requirements, and model payment.

  • Date: Thursday, August 10 at 2 p.m. – 3 p.m. ET
  • Registration: To register, click here

Interested in GUIDE? 

 

Referral Rejection Rates, Patient Complexity In Home Health Care Reaching All-Time Highs

Home Health Care News | By Andrew Donlan

While referrals to home health care are ballooning, providers are rejecting them at an unprecedented rate.
 
As hospitals scramble to place patients in the hands of appropriate post-acute care providers, skilled nursing facilities’ referral volume has rebounded.
 
Home health referral volume also remains above pre-pandemic levels, but providers are struggling with staffing challenges and sicker patients. Data from WellSky’s 2023 Evolution of Care Report shows just how significant those issues have become.
 
“We’re entering a new era of care delivery and there is a dramatic shift happening in the health care landscape,” Lissy Hu, president of connected networks at WellSky, said in a statement. “Providers, whether it’s the hospital or the doctor’s office, and health plans need to be connected to post-acute and home-based providers as care shifts to home and value.”
 
In April, Hu told Home Health Care News that referral rejection rates “very much remained an issue” at a time when home health referrals were at an all-time high.
 
“Our data shows that it’s truly a care continuum – that what happens in the post-acute setting has a direct impact on the hospital setting and vice versa – so improving patient outcomes requires a holistic cross-continuum approach,” she continued.
 
Specifically, 76% of patients being referred to home health care were not being accepted as of December 2022. That number was up from 54% in 2019.
 
WellSky’s data analysis is based on proprietary data that draws from over 2,000 hospitals and 130,000 post-acute care providers.
 
This issue has forced providers to be more up front with their referral partners in recent years, acknowledging which patients they can take and which patients they can’t.
 
“You just need to be transparent,” Geoffrey Abraskin, a senior vice president at Amedisys Inc. (Nasdaq: AMED), told Home Health Care News. “If you’re truly in a partnership, there’s going to be an understanding. Just like hospitals go on diversion – if their ED is full, for example – home health does the same thing. So, we’re in the same boat as them. We just try to be very proactive and upfront with our capacity or limitations.”
 
Home health providers are also caring for more complex patients than ever before.
 
WellSky data shows that patients are now at least 6% more acute, on average, than they were in 2019 at discharge.
 
Patients are more likely to be experiencing neurological, alcohol-use and drug-use disorders. They are also more likely to be suffering from psychosis or pulmonary circulation diseases.
 
“Anecdotally, we’ve been seeing that for years,” Bud Langham, EVP of clinical excellence and strategy at Enhabit Inc. (NYSE: EHAB), told HHCN earlier this year. “It started a long time ago, but certainly accelerated during COVID because there were fewer inpatient beds and staff to take care of those patients. In the home health industry, we were asked to take care of patients who were sicker than what we were used to.”

 
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