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In Post-Acute Care, Many Prefer to Go Home
Managed Healthcare Executive | By Ron Southwick
More patients are opting for home health services over skilled nursing facilities, and a new analysis expects that trend to continue.
In an analysis of post-acute care trends, Trella Health noted an uptick in home health instructions between 2020 and 2021, while skilled nursing instructions dipped over the same time frame. In fact, the skilled nursing industry’s struggles look to continue for the foreseeable future with no end in sight, the report states.
In its 2021 Post-Acute Trend Industry Report, Trella Health also pointed to the growth of Medicare Advantage enrollment, opportunities for telehealth and projections for expansion of the hospice industry. Trella Health, based in Atlanta, Ga., provides data analytics for post-acute care providers, including home health agencies, skilled nursing facilities and hospice providers.
After a dip due to the emergence of COVID-19, post-acute care instructions rebounded to pre-pandemic levels. Between the fourth quarter of 2020 and the third quarter of 2021, post-acute care instructions rose to 52.2%, up from 51.1% during the previous four quarters.
Here is a rundown of some key findings in the Trella Health report…
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Despite Strong Bipartisan Support, Choose Home Facing Roadblocks
Home Health Care News | By Patrick Filbin
Although Congressional support continues to grow for the Choose Home Care Act of 2021 in Washington, D.C., the legislation remains in limbo.
Other pieces of legislation for lawmakers have pushed the Choose Home bill down the priority list, but National Association for Home Care & Hospice (NAHC) President William A. Dombi is hopeful something will come of it soon.
“Priorities in Washington became politics,” Dombi told Home Health Care News last week at the Capital+Strategy conference. “The amount of air in Washington to deal with new things kept disappearing.”
Choose Home — among other things — supports in-home care alternatives to skilled nursing facilities (SNFs). If enacted, the legislation would enable certain Medicare patients to receive extended care services as an add-on to the existing Medicare home health benefit for 30 days following a hospital stay.
In addition to receiving skilled nursing or rehabilitation services from their home health provider, for example, a patient could potentially receive meals, non-emergency transportation, remote patient monitoring and more.
The idea is to give today’s highly diversified in-home care providers more flexibility and financial support to keep at-risk Medicare beneficiaries at home and out of costlier facility-based settings, in turn saving the U.S. health care system hundreds of millions of dollars a year.
Endorsed by the AARP and supported by a long list of home-based care advocates, Choose Home started gaining momentum on Capitol Hill early in 2021.
Now that Congress is through the budget and the U.S. government is trying to figure out how to properly aid and assist Ukraine, there should be time for Choose Home in political schedules, Dombi said.
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HHS Renews Public Health Emergency, Keeping Key Home Health Waivers in Place
Home Health Care News / By Robert Holly
The U.S. Department of Health and Human Services (HHS) on Wednesday opted to renew the COVID-19 public health emergency (PHE), keeping in place several regulatory waivers that have been critical lifelines for home health and hospice operators since the start of 2020.
While the extension itself is not surprising, it offers further stability as operators struggle with workforce shortages and general inflation, among other challenges. On top of that, the move gives hospital-at-home stakeholders extra time under the Acute Hospital Care at Home waiver, as they work on gaining support for corresponding legislation in both the House and Senate.
The PHE has been repeatedly renewed since implemented by the Trump administration over 24 months ago.
Without action from HHS and the Biden administration, it was set to expire on April 16.
“With more than two years having passed since the COVID-19 pandemic began in early 2020, questions are being raised about when to end the public health emergency declarations made by the federal government early on, with some advocating for their extension and others calling for their expiration,” Kaiser Family Foundation experts wrote in a recently released issues brief. “There are numerous implications to ending these emergency declarations.”
Wednesday’s extension is for another 90 days, which will carry the PHE into July.
Under the PHE, federal regulators have waived or modified normal requirements for Medicare and Medicaid providers, plus private health insurers. While some waivers have focused on reducing reporting and supervision requirements, others have revolved around new telehealth allowances and funding support.
Medicare-certified home health agencies, in particular, have had access to a long list of waiver flexibilities…
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Public Health Emergency Renewed to July 15, 2022
Last Wednesday, U.S. Health and Human Services Secretary Xavier Becerra renewed the COVID-19 public health emergency declaration, effective April 16.
HHS will provide states and territories with no less than 60 days’ notice prior to the termination of the public health emergency declaration for COVID-19. In the meantime, certain waivers from the Centers for Medicare and Medicaid Services for certain requirements under section 1135 of the Social Security Act will continue to be in effect. Read the latest at COVID-19 public health emergency declaration renewal. |
Home Health Agencies Should Brace for PDGM Battle Later This Year
Home Health Care News / By Patrick Filbin
Home health providers should brace themselves for a potential Patient-Driven Groupings Model (PDGM) battle with the U.S. Centers for Medicare & Medicaid Services (CMS) later this year.
Implemented on Jan. 1, 2020, PDGM is the largest overhaul to how Medicare-certified home health agencies are paid in two decades. And normally when CMS implements something of this magnitude, there are ongoing tweaks and changes to make sure reimbursement is fair to both the government and providers.
That balancing act is even more important with PDGM, which must be budget neutral, as mandated by Congress.
Yet because of the COVID-19 pandemic, any major recalibrations or corrections to PDGM’s foundation have, so far, been delayed, according to National Association for Home Care & Hospice (NAHC) President William A. Dombi. That could begin to change later in 2022, when CMS is gearing up to release its proposed payment rule for 2023.
“We’ve been having those conversations for three years,” Dombi told Home Health Care News during an interview at the Capital+Strategy conference. “We had those conversations before PDGM was put into the law because we knew, going down the pike, you’re going to be seeing what we’re facing from a Medicare home health priority perspective.”
Typically, CMS releases its proposed payment rule in late June or early July. With two years of PDGM observations and the public health emergency starting to wane, the agency may float big adjustments at that time.
“The concept [of budget neutrality] is a lot easier to state than it is to apply,” Dombi said. “The application of it, right now, has been … kicked down the road for a couple of years with the explanation being, ‘The data is not yet sufficient for us to make the judgment on it.’ The data will be sufficient for 2023.”
Now, Dombi said, CMS will be determining what the methodology is for determining whether the budget has been neutral or not.
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