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:

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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.

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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.

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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.

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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.

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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.