New PDGM Educational Material Now Available!

April 22, 2019

In a partnership with the National Association for Home Care, we are pleased to extend to you a special NAHC discount on several PDGM educational offerings. As a member of HCA of MA, you will receive the NAHC member rate* when you purchase any or all of the following:  1) the PDGM: Strategies for Success in 2020 and Beyond video;  2) the individual webinars;  3) seven-part Webinar Series;  or 4) the package,  which includes both the PDGM Video and the PDGM Webinar Series – at an unbeatable price!

Registration includes giving your entire team access to these materials. Each individual can access them separately or you can use them for a group education.  It’s  up to you!

Click on the links below to get started!

For one low price, you and your entire team will have access to these materials, access them separately or as a group, it’s up to you!

Click on the links below to get started!

PDGM Video

We’ve developed an intensive, in-depth, online training that will prepare you and your entire Medicare home health agency to transition smoothly and successfully to PDGM in 2020 and beyond. If you weren’t able to attend one of the 12 National Summits across the country, don’t worry. PDGM: Strategies for Success in 2020 and Beyond features the same top PDGM experts who educated thousands at our National Summits, and you can learn their insights without leaving your home or office. Even better, for one low price all of your staff can receive the training they need. Purchase the video

Webinar Series

These webinars will be recorded for access anytime and anywhere.  For descriptions and objectives, click here

PROMO CODE FOR INDIVIDUAL WEBINARS: PDGM-Ind-MA01

Date & Time Title Presenter
May 2, 2019
2:00-3:00 PM ET
PDGM Practical Overview Sue Payne REGISTER
May 9, 2019
2:00-3:00 PM ET
PDGM Operations Impact: Referral Source & Intake Maria Warren REGISTER
May 21, 2019
2:00-3:00 PM ET
PDGM Operations Impact: 30 Day Periods, LUPAs, Supplies Diane Link REGISTER
June 6, 2019
2:00-3:00 PM ET
PDGM: Coding / Documentation Review / Revenue Cycle Melinda Gaboury REGISTER
July 11, 2019
2:00-3:00 PM ET
PDGM: Interdisciplinary Considerations Karen Vance REGISTER
August 15, 2019
2:00-3:00 PM ET
PDGM: Electronic Medical Record Readiness Matt Garcia REGISTER
August 16, 2019
2:00-3:00 PM ET
Clinical Management of PDGM Risks Karen Vance REGISTER

Registration

PRODUCT State Association Member Price w/ Code Register
Single PDGM Webinar (1 of 7) $99 use links above
PDGM Webinar Series (all 7) $199 PURCHASE
PDGM Video (5.5 hrs) $199 PURCHASE
PDGM Video (5.5 hrs) and PDGM Webinar Series
$349 PURCHASE

PROMO CODES ARE AS FOLLOWS:

Individual Webinar Code – PDGM-Ind-MA01

PDGM Webinar Series (all 7 webinars) Code – PDGM-MA01

PDGM Video Code  –  PDGM-MA01

Combo – PDGM Video and Webinar Series (all 7 webinars) Code – PDGM-Combo-MA01

Return to www.thinkhomecare.org.


A New Version of OASIS is Coming!

April 18, 2019

Is your staff just getting used to completing OASIS-D?  Surprise,   CMS recently announced there will be a new version for 2020!

It was a surprise to many when CMS declared during the April 3rd, Open Door Forum, that effective January 1, 2020 there would be a new version of OASIS. I know I was thinking at first that the presenter misread the effective date, but apparently this update is needed to support the Patient Driven Grouping Model (PDGM).  One more thing for HHA to deal with. But, HCA of MA will be here for you.  (See link at end to out Fall 2019 OASIS training.)  

Thankfully though, after reviewing the  CMS Memorandum,   I realize that there are only a few minor changes.

Quick synopsis:   Two items will be added to the Follow-Up assessment:  M1033-Risk for Hospitalization and M1800-Grooming. These items should pose no problem since staff is familiar with answering these items at SOC/ROC. Surprisingly, the other change involves the “option” to no longer answer 23 items!  Rather than leaving the items blank,  the clinician will be required, however,  to respond by using the equal sign (=).

Here are the “optional” items for your convenience.

Start of Care/Resumption of Care (SOC/ROC)

• M1910 Fall risk Assessment

Transfer (TRN) and Discharge (DC)

• M2401a Intervention Synopsis: Diabetic Foot Care

• M1051 Pneumococcal Vaccine

• M1056 Reason Pneumococcal Vaccine not received

Follow-Up (FU)

• M1021 Primary Diagnosis

• M1023 Other Diagnoses

• M1030 Therapies

• M1200 Vision

• M1242 Frequency of Pain Interfering with Activity

• M1311 Current Number of Unhealed Pressure Ulcers at Each Stage

• M1322 Current Number of Stage 1 Pressure Injuries

• M1324 Stage of Most Problematic Unhealed Pressure Ulcer that is Stageable

• M1330 Does this patient have a Stasis Ulcer

• M1332 Current Number of Stasis Ulcers that are Observable

• M1334 Status of Most Problematic Stasis Ulcer that is Observable

• M1340 Does this patient have a Surgical Wound

• M1342 Status of the Most Problematic Surgical Wound that is Observable

• M1400 Short of Breath

• M1610 Urinary Incontinence or Urinary Catheter Presence

• M1620 Bowel Incontinence Frequency

• M1630 Ostomy for Bowel Elimination

• M2030 Management of Injectable Medications

• M2200 Therapy Need

HCA of MA next Blueprint for OASIS Accuracy will be held on November 4th and 5th. Option to take the certification exam will be on the 6th.

You can register for the course here.

Blog post by:  Colleen Bayard.


Electronic Visit Verification (EVV) System Resource Page Now Available for HCA Members!

April 17, 2019

The Home Care Alliance of MA is happy to announce a resource page completely dedicated to keeping Home Health Care Providers informed for the upcoming Electronic Visit Verification (EVV) Mandate. You can access this page by going to www.thinkhomecare.org/EVV

Massachusetts Executive Office of Elder Affairs is moving forward with “deliberate speed” to implement the federal EVV mandate.  Massachusetts is developing a hybrid model for EVV, allowing agencies to use their current EVV vendor or choose any vendor that can collect and transmit the required data elements.  For those agencies without an EVV vendor, Massachusetts has contracted with Optum to design a free EVV system.  The current schedule would require personal care agencies that participate in the MA Home Care program that currently have an EVV system in place to begin testing in late 2018. Personal care agencies that don’t currently have an EVV system in place will have additional time to either go live with the Optum system or select and implement an EVV system from another vendor.

According to data collected by EOEA, well over half of the EOEA home care provider agencies in MA do not currently have an EVV vendor.  These agencies will have to make important purchasing decisions within the next year. This page is created to provide the must up to date information on EVV including important resources, vendor information and more.

EVV Vendor Webinar Series

Along with access to to important documents, websites, and contact information – HCA of MA has developed a monthly webinar series that allows EVV Vendors a one hour webinar to demonstrate their platform to our members for FREE! The webinars are typically held the 2nd Tuesday of every month and are recorded in the case you cannot listen to the series live.

The current schedule is as follows:

March 19th – Agency Workforce Management (Recording Available)

April 9th – HHAeXchange (Recording Available)

April 23rd – CellTrak

May 14th – Homecare GPS

June 11th – HomeCareIT

July 9th – Sandata

August 13th – 4Tellus

September 10th – ClearCare

REGISTER ONLINE

*Registering online gains you access to all webinars currently scheduled and any future webinars that may be scheduled

 

EVV Implementation: One Agency’s Experience

One additional resource webinar will be a one hour program with an agency member: HebrewSenior Life. Members of the HSL Leadership Team as they share their experience with implementing an EVV platform.  They will offer product highlights and the benefit and impact experience for clients, workforce, operations, and finances. They will also share their approach to the establishment of policies, procedures, and timelines for success with onboarding for caregivers and leaders.

This webinar will be held on Wednesday, April 24 at 1:00PM. This is also FREE to members!

REGISTER HERE

Access the EVV Resource page at: http://www.thinkhomecare.org/EVV


HCA and Northeastern University Partner on Nurse Symposium in June

March 21, 2019

These days, it seems like every week a new report is published sounding the alarm of a rapidly aging population across the United States and a shortage of workers prepared to care for this barreling silver tsunami. So much of the media coverage and research is focused on the paraprofessional workforce.

See for example, these reports/publications:

However, the Home Care Alliance member surveys indicate that the problem is broader than just a shortage of home health aides. The availability of a trained nursing workforce to meet a growing home-based health care delivery system is also emerging as an issue. Compounding challenges are impacting our ability as an industry to attract nursing students into home and community-based settings after nursing school.  That is why, on June 7th the Home Care Alliance of Massachusetts and Northeastern’s School of Nursing are hosting a symposium on the very topic of building a home care nursing workforce at Northeastern University from 9AM – 3PM.

The event, titled: Nursing Call to Action: Building a Nursing Workforce to Deliver Complex Care at Home, will bring together more than 25 nursing schools and 25 home health providers for a day-long session. The program will kick-start a dialogue brainstorming new approaches for preparing and exposing Massachusetts nursing students for an increasingly intensive health delivery system in the home.

This event will look past the issue of reimbursement rates or ever-changing reforms at CMS, and instead will focus on four key areas:

  1. Identifying knowledge and skills gaps for LPN/RN new-grads and what changes can be made to address the gaps and develop competencies in executing highly complex services
  2. Elevating the visibility to nursing schools of the growing demand for home-based services and the need to expose students to possible careers in home care nursing
  3. Identifying strategies on recruitment as new-grads and experienced nurses prepare for possible careers in home care nursing
  4. Identifying barriers and strategies to get home health agencies more involved in clinical placements for nursing students

If you would like more information on this event, please reach out to Jake Krilovich. Please note: There is limited space for this event!


Full Brochure for 2019 NEHCC Now Available

March 8, 2019

The full conference program and schedule for the 2019 New England Home Care and Hospice Conference & Trade Show is now available for download.

View this document on Scribd

The NEHCC is the region’s premier event for home care and hospice agencies. It’s hosted by the six New England state home care associations, which collectively represent nearly 400 organizations. The 2019 NEHCC will be held June 5-7, 2019 at the Sea Crest Beach Hotel in Falmouth, MA.

For more information about the conference, or to register to attend, visit www.nehcc.com.

Return to www.thinkhomecare.org.


Home Health, EHRs and Data Interoperability

February 27, 2019

In 2011, the Centers for Medicare and Medicaid Services launched the “Meaningful Use (MU) initiative to incentivize certain sectors in the US health care system to move toward electronic health records (EHR) that would be used in a meaningful manner that allows for the electronic exchange of information to improve continuity and quality of care. Significant financial incentives were provided to “eligible providers” – essentially defined as hospitals and physician practices. More than $20 billion was spent and more that 600,000 eligible providers were enrolled. Home health, behavioral health and skilled nursing facilities were not eligible.

Now, it seems there is some limited acknowledgement that it may be time to rethink that. In a proposed rule relative to interoperability just published in the Federal Register, CMS is including – as a Request for Information – an ask for any feedback as to how to improve data interoperability for providers that have as yet received any incentives for using electronic health records.

“Transitions across care settings have been characterized as common, complicated, costly, and potentially hazardous for individuals with complex health needs. Yet despite the need for functionality to support better care coordination, discharge planning, and timely transfer of essential health information, interoperability by certain health care providers such as long term and PAC, behavioral health, and home and community-based services continues to lag behind acute care providers,” the proposed rule says.

CMS acknowledges that a contributing factor to the lag in Interoperability among post-acute care providers was that they were not eligible for incentives under the program formally known as meaningful use. CMS asks for input on specific ways it could financially help these sectors adopt and use technology.

CMS also asks for feedback on measurement concepts and quality improvement steps that could feasibly be applied to post-acute care, behavioral health and home and community based-services providers. Given that mandate in the IMPACT ACT that certain patient assessment data should be standardized and CMS is interested in feedback as to what parts of that data set — or the whole IMPACT Act data set — would be appropriate to include.

Adding some fuel to what may be an obvious fire (no incentive = limited movement) is a just published study in the Journal of the American Medical Directors Association that examined gaps in communication between hospital and home health care staff, concluding that some could have serious medical consequences.

The authors surveyed nurses and staff at 56 home health agencies throughout Colorado. Participants were sent a 48-question survey covering communication between hospitals and agencies, patient safety, pending tests, medication schedules, clinician contact and other areas. Although almost all (96 percent) respondents indicated that Internet-based access to a patient’s hospital record would be at least somewhat useful, fewer than half reported having access to EHRs for referring hospitals or clinics. No surprise: getting medication doses right due to conflicting information was identified as a major problem.

Their conclusion: Future interventions to improve communication between the hospital and HHC should aim to improve preparation of patients and caregivers to ensure they know what to expect from HHC and to provide access to EHR information for HHC agencies.

Comments to CMS will be due in April. Date not yet announced.

Return to www.thinkhomecare.org.


PDGM Fix Introduced, Advocacy Needed

February 21, 2019

Last week, a bipartisan group of senators, led by Sen Susan Collins (R-ME)  introduced what will be a most important legislative priority for HCA of MA this year.  Senate bill (S.433) will curtail the so-called $1 billion “behavioral adjustment” cut under the Patient Driven Groupings Model (PDGM) to which all of home health is transitioning in 2020.  Among, many other changes, PDGM will move home health from a 60 to a 30 day payment unit. This is the most significant change to home health payment since the Prospective Payment System was introduced in 2000.

The Congressional action that called for a home health payment overhaul required that the new payment model be budget neutral against current spending levels. However,  the legislation also allowed that CMS to consider “behavioral  adjustments” defined as industry actions that would be taken to increase payment under the new model, unrelated to patient case mix changes. CMS has used this authority very broadly to institute a payment adjustment in the first year of PDGM based on “assumptions” of behavioral changes, and that adjustment calls for a 6.42% base rate reduction, or a possible $1b reduction in payments.

S 433 would prohibit CMS from making any pre-rate change reductions based on assumptions and instead to phase in any adjustments (either up or down) based on observed evidence (i.e., data supported) changes in provider behavior. The objective would be to achieve budget neutrality by 2029. This later piece addresses concerns the Congressional Budget Office (CBO) expressed regarding whether a similar bill introduced last session was truly budget neutral. S.433 also would allow Medicare advantage plans and Center for Medicare and Medicaid Innovations (CMMI) to waive the “confined to home”  provision when in the best interest of a Medicare beneficiary.

Regardless of the “behavioral adjustments,” the PDGM model is expected to have a tremendously varied impact state by state and agency by agency.  A significant amount of this impact is related to a Congressional  requirement that the payment model no longer use the volume of therapy as a payment level determinant.  (Something MEDPAC has been calling on CMS to do for years.)   The state of Florida, where therapy visits average 10.45 per episode of care is set to “lose” the most – projected at $141 million.  California on the other hand, where the average therapy utilization per episode was 5.76,  will be the largest gainer.  MA (need numbers from Tim)  Note: S 433 does not seek to make changes to the structure of the payment model that produces these changes.

It is important to reflect on CMS’ proposal in 2017, Home Health Groupings Model (HHGM) and how we arrived to where we are today. At the time, HHGM represented similar changes to the payment model, without soliciting industry feedback and some estimates predicting a 15% reduction in payments. As a result, the industry unified itself behind one message: that CMS withdraw its proposal and engage stakeholders to come up with an alternative. Upwards of 13,000 emails were sent to Congress from the industry, 49 members of the U.S. Senate and almost 160 members of the U.S. House of Representatives signed onto letters to CMS echoing the request to withdraw HHGM. This was a remarkable show of mobilization by the industry and we’ll need it again to make modifications to PDGM.

At present there is no bill in the House, but it is expected that one will be forthcoming.  Strong early sign on support is critical to keeping this bill moving and HCA of MA will be urging members to contact the MA delegation to support S.433 and the companion house legislation to be introduced. Stay tuned for these advocacy alerts in our weekly newsletter and advocacy messages in the coming weeks.

HCA will also be hosting a number of member events to prepare for the payment transition.  While the full day PDGM programs in March in Northampton are sold out, there will be a high concentration of sessions on PDGM at the New England Home Care Conference and Trade Show in on June 5 -7 inn Falmouth. Watch here for more details.

In the meantime, send a message here to Senators Warren and Markey about the need for their support on this issue. 

Let’s do this home care – we cannot sustain $1 billion in cuts based on assumptions, not facts!


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