2010 Private Care Guides SOLD OUT!

As of this past Friday, the Alliance has sold out of copies of its 2010 Guide to Private Home Care Services!

That’s 12,000 copies distributed to Councils on Aging, ASAPs, hospitals, VA centers, doctors offices, and — most importantly — families and individuals around Massachusetts.

Copies of the 2011 Guide are available for pre-order, and will begin shipping next month.

Return to www.thinkhomecare.org.

Videos from the Senior Spectacular Event

The Home Care Alliance was involved in exhibiting and speaking to seniors about home care services at the 2010  Senior Spectacular in Worcester. The Massachusetts Falls Prevention Coalition was a huge part of the event with an exhibit booth and activities for the seniors in attendance. Below is an introduction to those activities and a Tai Chi demonstration aimed at increasing balance and helping to prevent falls.





ACO Committee Finds Consensus and Takes Other Issues Under Consideration

At today’s meeting of the state’s Payment Reform Commission consensus began to emerge about some ACO Framework issues while diverse opinions were voiced on others.   Consensus is emerging around ACO core capacities and the arrangements with primary care and specialty physicians; the former should (with only certain exceptions) be a member a single ACO, specialists can be in multiple ACOs.  There is consensus that consumers need to be able to seek care outside the ACO (a position the Alliance has supported), with the ACO responsible for these costs – except in circumstances of out of state care or catastrophic need.

Obligations of ACOs to include and be accountable for a broader range of services beyond primary acute inpatient care are still being debated.    The Home Care Alliance has submitted and made comments at meetings that in order for ACOs to avoid creating (or recreating) a hospital-centric, ‘siloed’ system of care, the qualifying criteria must include a capacity for coordinating care across primary, acute and post acute services.       This capacity could be in an integrated model, or in a more virtual manner, but the later (virtual model) should be required to be constructed with strong performance based contracts or other explicit arrangements for care across the continuum.   The position for not mandating a broad continuum of services is espoused by  members of the Committee who advocate  giving ACOs broad flexibility in terms of scope of services for which they are responsible.  A limited scope of responsibility, they argue, might encourage more early interested parties.   Secretary Bigby expressed a position that the ACO must be responsible for an assigned patient’s total health, which would argue for having a full continuum of services.

The meeting ended with some discussion of ACOs having an unintended consequence of changing the market in ways that certain essential community services (ER’s, public health programs) are lost.  This was acknowledged but with little resolution.

New Advocacy Message on Nurse Delegation

A new message is available on the HCA’s Legislative Action Center in an effort to get the Nurse Delegation Bill (Senate Bill 860) through the House and to the Governor’s desk.

This message is aimed at the House Committee on Bills in the Third Reading, which is the last stop before the House can advance this important legislation.

See the top message titled “Please Pass Nurse Delegation for Better Home Health” and click below the title to take action!

Return to www.thinkhomecare.org.

Family Caregiver Appreciation Day, Nov. 16

Taking care of a loved one who is elderly or disabled is never a simple task, but the Home Care Alliance of Massachusetts aims to make it a little easier with a unique event called Family Caregiver Appreciation Day, which will be held at the Hogan Center at College of the Holy Cross on Tuesday, November 16 from 10:00am to 3:00pm.  The all-day event marks November as Family Caregiver Appreciation Month.

The day will include workshops conducted by the Elder & Disability Law Advocates, Massachusetts Commission for the Deaf and Hard of Hearing, Alzheimer’s Association of Massachusetts, Philips Lifeline, Central Mass. Agency on Aging, Commonwealth Medicine, and Aviv Centers for Living. A critically-acclaimed independent short film titled “The Beautiful Hills of Brooklyn,” which deals with aging issues, will see its first local showing. Attendees will also hear inspirational presentations from a pair of authors who have written about caregiving.

Walgreens Pharmacy will conduct a flu shot clinic, and the MA College of Pharmacy and Health Sciences’ Pharmacy Outreach Program will provide attendees with a ”Medication Check-up” to review meds and answer any questions they have.  Caregivers can bring any medications (including prescriptions, over- the-counter medications, vitamins and supplements) they or a loved one currently takes on the day of the event.

Interested agencies can help the Alliance promote the event by distributing this flier to patients, families, and around your local community.

Several agencies have already committed to supporting attendees at the event by donating homemaker/aide hours to a “Free Care For Caregivers” bank to provide respite care that day to allow family caregivers to attend the event.  Agencies interested in donating respite care hours should contact Patricia Kelleher as soon as possible!

Agencies can also register family caregiver attendees yourself at your agency and send a single list to us.  We would like some form of contact information – either a mailing address or email address – in addition to the names of attendees so we can send confirmations and additional info about the event.

Return to www.thinkhomecare.org.

How is An ACO Like a Unicorn? – and Other Questions Raised at October Payment Reform Meeting

At the October 6th meeting,  the Committee charged with dissecting and debating formation of new payment reform strategies in Massachusetts raised as many questions as it answered. One of the bigger areas for today’s debate: the degree of prescriptiveness or flexibility of authorizing statutory language.  While there was general agreement among business leaders and trade associations for large provider groups (hospitals and doctors, in particular) that flexibility be the goal, there was some concern that too much flexibility might dilute the reform’s key provision: Accountability.   (“If we don’t spell out who is accountable for what and too whom,   we risk having none,” was how one participant put it.)   Home health and behavioral health providers were united in expressing concern that too much “flexibility” could undermine access to  essential “downstream” services in the interest of cost savings.

Other questions debated without little resolution: what is the relationship to be between ACOs and insurers?   Can models exists with very different levels of  integration (full vs virtual, of payment (fully bundled, partially for only certain services)?  How prescriptive should oversight be on collecting and reporting of quality data?   The idea of allowing – at least initially – many models had significant (although not universal support), including the Alliance’s. There was at least one expressed opinion that virtually  integrated ACOs could simply mimic the fee for service system that the state is committed to moving away from.  This was somewhat countered by the support for transparency and shared “performance risk” across collaborating entities that has been shown in some demonstrations, such as STAAR,  can begin to improve outcomes.   HHS Secretary Judy Ann Bigby indicated support for tiers of  integration that could be seen as “stages of payment reform development” with an oversight Board assessing how various models are working and then changing incentives to move system towards the most effective.

As to the apropos unicorn analogy, it came from Mass Hospital Association VP Jim  Fitzpatrick.  Fitzpatrick quipped that ACOs were like unicorns in that no one has ever really seen one locally, but we all seem to know what they look like.   Indeed!