Month: November 2011

More News on Care Transitions Funding

Despite tremendous national interest, the new CMS Center for Medicare and Medicaid Innovation (CMMI) has  funded only seven applicants to date under its new Care Transitions project.   While CMS will not say how many applications they received and rejected in the first round, or how many are pending review, information is slowly coming to light about the funded projects.  For entities still looking to apply – and CMMI is clear that they continue to want applicants!! – the information is potentially instructive.

One of the funded sites – in Greater Cincinnati – shared on the Medicaring blog (hosted by the non profit Altarum Institute) that they plan to serve about 5400 beneficiaries and save about $1 million using what they call a “modified Coleman Model.”   The same blog in a slightly earlier post ran an interesting piece on developing a “blended” per person rate as required by the Section 3026 budget worksheet.

Those who want more detail on what has been funded, can find a summary of projects on the CMS Care Transitions project website.  Two threads common to all projects and stressed on a call with awardees has been that  1) funded sites have some care transitions experience with a specific model and 2)  multiple hospital partners are involved.  In the case of the latter, CMS wants to see actual agreements in place, not just letters of support.

EOHHS Hosting FY2013 Budget Hearings

The Home Care Alliance is collecting written testimony and encouraging those interested to present oral testimony for upcoming hearings being hosted by the Executive Office of Health and Human Services (EOHHS) on the upcoming Fiscal Year 2013 budget.

Indications have been made that the upcoming budget will be just as difficult as those in previous years so it is important that home care agencies show up and submit written comments to convey the significance and value of the services they provide. EOHHS is seeking input about the best ways to preserve core services to the fullest extent possible without additional expenditures. As such, the Alliance suggests that agencies promote work in care transitions, disease management, and the general value of keeping people independent at home. The Alliance is also pushing for MassHealth coverage of telehealth technology as well as legislation on nurse delegation of medication administration, which we encourage people testifying to include in their comments.

Secretary JudyAnn Bigby, M.D., and the Assistant Secretaries at EOHHS will be on hand for both hearings so comments should begin by addressing them accordingly. The two hearings will be held this week and next week at the following dates and locations:

Friday, December 2, 2011 from 3:00-6:00 p.m.
Department of Mental Health Western Massachusetts Area Office
Northampton Haskell Building
1 Prince Street
Northampton, MA 01061

Friday, December 9, 2011 from 2:00–6:00 p.m.
Agganis Arena at Boston University
Francis D. Burke Club Room
925 Commonwealth Avenue
Boston, MA 02215-1204

Due to the number of individuals anticipated to attend the hearings, oral testimony will be limited to three minutes per individual. In the interest of time, representative panels are welcome and will be limited to a total of five minutes of oral testimony. If a number of home care agencies are interested, they will be added to a panel as HCA will be attending and testifying at the Boston hearing on December 9th. HCA asks that you also inform us if you sign up to attend or submit written comments on your own.

If you need accommodations please call 617-573-1600 and let the receptionist know.  Additionally, if you are planning to present oral testimony at the Boston hearing, please note that you must be in the building by no later than 5:50 p.m.

Written testimony can be sent to the Home Care Alliance to be submitted collectively, or may be mailed to:

Secretary JudyAnn Bigby, EOHHS
One Ashburton Place, Room 1109, Boston, MA 02108
Or emailed to:  eohhshearings@massmail.state.ma.us

Return to www.thinkhomecare.org.

Copays Avoided: Super Committee Fails to Reach Deal by Deadline

The Joint Select Committee on Deficit Reduction, also known as the Super Committee, charged with coming up with a plan to cut the national deficit by $1.8 trillion over the next decade failed to do so by their November 23rd deadline.

Although the group could not come to a compromise, the lack of a deal is a temporary win for home care because of what was on the table. Copayments on Medicare home health services were proposed and considered from several angles, including President Obama and the Medicare Payment Advisory Commission (MedPAC).

Now, because the six Democrats and six Republicans on the committee could not come to a compromise, a sequestration process begins where automatic and across-the-board spending cuts will be triggered and are planned to begin in January 2013. The debate on the subject, especially in Congress and for the upcoming election, will certainly not stop until that time and some course of action prior to the commencement of automatic cuts is likely to alter current plans.

See an official statement from the National Association for Home Care & Hospice on the Super Committee and avoiding a copay for Medicare home health services.

Senator John Kerry, a member of the 12-person committee, has proven once again to be a champion for home care issues. The Alliance has been in contact with his staff throughout the process who relayed HCA’s advocacy to the Senator. Such advocacy will need to continue until it is revealed how any cuts from the sequestration process will be doled out.

HCA will provide updates as the deficit reduction debate continues.

Return to www.thinkhomcare.org.

Health Care Innovation Challenge Announced

A new funding opportunity has been announced by the CMS Center for Innovation (CMMI).

The Health Care Innovation Challenge, relative to Section 3021 of the Affordable Care Act, will award funding to innovative projects that test ways to deliver the three-part aim of better health, better health care and lower costs through improved quality for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollees.

Preference will be given to projects that focus on rapid workforce development. Eligible applicants include provider groups, health systems, payers and other private sector organizations, faith-based organizations, local governments, and public-private partnerships and for-profit organizations. States are not eligible to apply. Up to $1 billion is available for this opportunity. Individual awards expect to range from $1-$30 million over a three year period. Applications are due January 27, 2012.

If any home care agencies are interested in this opportunity, the Alliance will be providing assistance and guidance as with the Community-Based Care Transitions Program.

Return to www.thinkhomecare.org.

CMS Community Based Care Transitions Program Update

The Centers for Medicare and Medicaid Services (CMS) released more deadlines where they will be reviewing applications for the Community-Based Care Transitions Program (CCTP) and also announced seven accepted applications and further guidance on crafting a successful application.

The new panel review dates as well as those previously announced that are coming up are as follows:

  • January 12 & 13, 2012 – Applications must be received by December 22nd to be considered for this review.
  • January 31 & February 1 – Applications must be received by January 11th to be considered for this review.
  • February 17 & 20 – Applications must be received by January 30th to be considered for this review.

The CCTP Program fact sheet is helpful in that it contains a lot of the information in the Q&A’s, but in a more concise document. The document is mostly a reiteration of the program requirements and what CMS is looking for in an application.

The seven sites that are the first to be awarded include one program in the Merrimack Valley and North Shore of Massachusetts. CMS and all seven sites will be part of  a conference call on Tuesday, November 29th from 1:00pm-2:30pm to allow stakeholders to hear directly from some of the newly selected sites. CMS staff will be available to answer questions. Call in #: (800) 837-1936 Conference ID: 29693317.

If any home care agencies are interested in pursuing or continuing to pursue this opportunity, please contact the Home Care Alliance for assistance.

Return to www.thinkhomecare.org.

 

Caring Magazine Highlights Massachusetts Care Transitions Programs

The great work being done by home care agencies in Massachusetts around care transitions was highlighted in an article in the current issue of Caring Magazine, the monthly publication of the National Association for Home Care & Hospice (NAHC).

In the article written by the Home Care Alliance, the focus is on four agencies involved in the STAAR project (State Action on Avoidable Readmissions) and how their collaborative programs have changed how care transitions are handled.

Additionally, the Home Care Alliance’s “Opt-In” document, a guide to Optimum Performance Standards for Transitions to and From Home Health, is highlighted and shown as a beacon for the work performed by these four agencies and any other agencies or  providers working with home health to improve care transitions.

Return to www.thinkhomecare.org.

 

 

 

It’s All About Innovation

The Centers for Medicare and Medicare Services (CMS) announced yesterday that they are offering $1 billion in grants to providers and payers who propose “the most compelling new ideas to deliver better health, improved care and lower costs” for the Medicare, Medicaid and CHIP populations. CMS noted that priority will be given to projects that can begin within six months after the award is granted.

CMS has identified three primary objectives of the Innovation Challenge funding:

  1. Engage a wide variety of innovation partners and test new care delivery and payment models that promote better care, better health, and reduced costs;
  2. Identify new models of workforce development, deployment, education, and training that support new models; and,
  3. Support innovators who can rapidly deploy (within six months of award) through new ventures or expansion of efforts to new populations, in conjunction with other private and public sector partners.

The Home Care Alliance is hosting our own members Innovation Showcase on December 7th at the John F. Kennedy Library. At this event, seven member agencies will present their successful work in agency transformation in areas of care transitions, readmissions reductions,  end of life care,  and more.   Senator President Therese Murray will be one of the invited guest speakers.

Join us on December 7th and be inspired.

Letters of Intent for the CMS program are due December 19th.

CMS Posts Final Rule for 2012 PPS Rates

CMS this week posted the final rule for Medicare home health PPS rates for calendar year 2012.  The finalized rates are slightly better than the proposed rates that CMS released in July, due to the fact that CMS has accepted industry recommendations to phase-in the case mix creep adjustment over two years, applying a 3.79% adjustment in 2012 and reserving 1.32% for 2013. Still, the 2012 national standard episodic rate of $2138.52 is a reduction from the 2011 rate of $2192.07.

The final 2012 rate is represents a 2.4% reduction from the 2011 rate, the result of a combined 2.4% market basket index inflation update, a 1% reduction in the inflation update required by the health care reform law, and a 3.79% case mix creep adjustment.
The final rule also adjusts the case mix weight for every HHRG to adjust for budget neutrality after removing eliminating hypertension as a factor in the calculation.  The rule also reduces the weights on high-therapy episodes and increasing weights on non-therapy episodes.

See this spreadsheet listing the updated rates for all HHRG’s in each MA geographic region.

In addition to setting forth updates to PPS, the final rule included some minor changes regarding face-to-face (F2F) encounters.  CMS is removing the modifier “attending” from the regulatory language to describe physicians who qualify as the physician who cared for the patient in an acute or post-acute facility. Most people considered the word ‘attending” to mean a community physician and not the in-patient physician.

Acknowledging that the Affordable Care Act did not preclude a patients’ acute or post-acute care physician from informing the certifying physician (physician who signs the 485) regarding their experience with the patient for the purpose of the F2F encounter requirement as an NPP can, CMS is also amending the F2F language to allow the acute or post-acute care physician to inform the certifying physician regarding the F2F.  The “community physician” could then complete the necessary documentation.

CMS believes these modifications allow additional flexibility in the process, making it easier for providers. Members with questions about the F2F changes can contact Helen Siegel at the Alliance office.

This finalized regulation will be the subject of an in-depth review by representatives of Blacktree Healthcare Consulting during the Alliance’s 2011 Financial Management Conference November 30 in Waltham.  Be sure to register today!

Return to www.thinkhomecare.org.

DHCFP Proposes New ASAP Rates, Hearing Scheduled

Implementing another provision of the Purchase of Service reform, the MA Division of Health Care Finance & Policy is assuming rate setting authority over ASAP rates effective January 1, 2012.  This week, DHCFP published the proposed rates for calendar year 2012, along with a notice of a public hearing to be held on Wednesday, December 14, 2011 at 10:00 AM at the DHCFP, Two Boylston Street, 5th floor, Boston.

DHCFP is proposing a new section of its regulations at 114.4 CMR 17.00: Rates for Certain Elder Care Services.  The proposed regulation establishes payment rates for Home Care and Enhanced Community Options Program (ECOP) services purchased by the Executive Office of Elder Affairs. The regulation establishes a bundled monthly payment to ASAPs for each client.  The proposed rate for the Home Care/Respite Care program is $266.52 per client per month.  This rate does not include any increase from the current rate. The proposed rate for ECOP is $662.12 per client per month, an increase of just $2.92 from the current contract rate.

Note that the DHCFP regulation does not set contractor agency rates.  Those will continue to be set through the Homemaker NOI process managed by EOEA.

The Alliance will be testifying at the public hearing.  Any agencies interested in providing testimony – either in person or in writing – are encouraged to contact James Fuccione at the Alliance office.

Return to www.thinkhomecare.org.

Celebrate and Raise Awareness: November is National Home Care and Hospice Month

Every year, the home care and hospice community celebrates and raises awareness of the services that help keep people independent and at home for National Home Care & Hospice Month and National Family Caregivers Month in November.

With the Joint Select Committee on Deficit Reduction debating proposals to reduce the nation’s debt by trillions of dollars, the advocacy focus for this year must focus on opposing suggestions to impose copayments on Medicare home health services. A message also has to be sent that home care paid it’s fair share, $39.7 billion over ten years to be exact, for implementing the Affordable Care Act as well as how the industry has been thrown years of regulatory reductions.

Home care and hospice are cost-effective methods that care for people in the setting where they are most comfortable and familiar. Please help the Home Care Alliance raise awareness of these important issues and services, but also celebrate the great work performed by aides, clinicians, managers and all staff that make those services possible.

Here are some ways to celebrate and raise awareness for National Home Care & Hospice Month:

For Providers –

Press Release: Tailor this press release on National Home Care and Hospice Month to include information about your agency and the services you provide. Then, distribute to your local newspaper and/or local senior newsletter (Please contact the Alliance if you would like assistance or have any questions). There is also a separate press release template for hospices.

Op-Ed/Letter to the Editor: Select from the Opinion-Editorial drafts below depending on your interest (HCA would be happy to work with agencies on more specific or localized op-eds or letters to the editor).

For Everyone –

Facebook: Go to the Home Care Alliance’s Facebook page and click “like” on the most recent status regarding Home Care Month.

Twitter: add the hash-tag #homecaremonth to your tweets this month and especially if you’re helping celebrate and raise awareness.

Posters: Download and print the posters below. Post in your home or office, or send to friends and colleagues.

Advocacy: Send an email advocacy message to legislators from HCA’s Legislative Action Center.

Resources for Caregivers:

-Order the Home Care Alliance’s new 2012 Guide to Private Home Care Services and see HCA’s other helpful publications.

–Alzheimer’s Disease caregiver tip sheet from the National Family Caregivers Association.

–Guide to Advance Care Planning from the National Hospice & Palliative Care Organization.

-Information on the Home Care Alliance’s Home Care Accreditation Program.

-Read President Obama’s Proclamation to honor National Family Caregiver’s Month.

Return to www.thinkhomecare.org.