Author: James Fuccione

Home Care Accreditation Reaches 60 Agencies

The Home Care Alliance is proud to announce that the Home Care Accreditation Program offered to private pay agencies, has now reached 60 providers!

See our press release on this important milestone below:

Home Care Accreditation Program Reaches 60 Agencies

New Stricter Standards for Private Pay Home Care Providers

Boston, MA – With brand new standards that are more stringent to protect patients, improve quality care and promote ethical business practices, the Home Care Accreditation Program offered by the non-profit Home Care Alliance of Massachusetts for private pay home care providers, continues to grow and has now reached it’s 60th agency.

“These new standards for Accreditation raise the bar for agencies, which only can lead to positive things for patients looking to remain independent in their homes,” said Home Care Alliance Executive Director Patricia Kelleher. “We hope the public realizes that this simply isn’t a stamp of approval, but a strong display of our commitment to quality and assurance that these agencies are meeting strict standards. Families deserve that peace of mind that their loved ones are receiving the best services out there.”

In the absence of meaningful licensure requirements for providers of home care services in Massachusetts, the Home Care Alliance established this Accreditation Program for Private Pay agencies, which do not receive reimbursement from Medicare or Medicaid.

The standards were developed over several months in consultation with 14 agencies throughout the Commonwealth.  These standards require that agencies submit an application and documentation to the Home Care Alliance of Massachusetts.  Alliance staff and member agencies then review the application to ensure that applicants meet all of the standards. Recently, the Home Care Alliance’s Board of Directors approved stronger standards that are meant to show the organization’s commitment to maintaining quality services.

Agencies seeking accreditation answer questions in fifteen categories, including training requirements, administrative protocols, and business practices.  They are required to show documentation in answer to questions regarding service plans between clients and the agency, procedures around responding to complaints, and their oversight of caregivers.

“We wanted to provide leadership for an area that is becoming more and more important in Massachusetts,” added Kelleher, “These standards highlight our agencies’ best practices, which will help guide members of the public as they choose who will take care of their loved ones in their homes. We aim to approve as many private care agencies as we possibly can in Massachusetts to prove our state’s commitment to quality home-based care.”

A full list of accredited agencies from across the state, and more information about the Accreditation Program standards, is available at www.thinkhomecare.org/accreditation.

Return to www.thinkhomecare.org.

HCA Comments to Federal Deficit Reduction Committee

With a home health copayment and other potential hazards hanging in the balance, the Home Care Alliance sent off an official letter to the Joint Select Committee on Deficit Reduction to reiterate strong opposition to what would amount to a “sick tax” on certain Medicare patients.

Following up on the recent visit to Washington DC, the letter was sent to the co-called Super Committee, which includes Massachusetts Senator John Kerry, and was copied to the state’s Congressional Delegation. The letter was especially timely, as a group of Alliance members and staff met last week with Senator Kerry to discuss specific concerns.  

The Alliance particularly targeted a recent proposal from President Obama to institute a copayment for Medicare home health services. If passed, the copayment would amount to $100 per 60-day episode on certain Medicare beneficiaries beginning in 2017. The copayment would not be imposed for episodes following a stay in an acute care facility and would apply to patients receiving five or more visits.

The Alliance’s letter, aside from opposing the copayments, also points out that Massachusetts has not experienced the same growth in the number of home health agencies as other parts of the country.  The Alliance argues that such broad payment reductions or copayments are punishing the wrong people and not targeting offenders of fraud and abuse. The Alliance also offers alternatives like a moratorium on new certified agencies, better targeting fraud and abuse in areas of substantial growth, and further capping outlier payments.

Agencies and concerned advocates are encouraged to submit comments opposing the copay and offering alternative solutions as mentioned in the Alliance’s letter to the Joint Committee on Deficit Reduction by visiting the comment submission page of their website.

The Alliance also has the opening remarks of Committee Co-Chair Senator Patty Murray (D-Washington) on the HCA YouTube page and will continue to provide updates as they become available.

Return to www.thinkhomecare.org.

HCA Issues Statement on Home Care Copay Proposed by President

In response to President Barack Obama’s proposal to impose a co-payment on Medicare home health services, the Home Care Alliance has issued a release to the press. Any home care agencies or concerned advocates is encouraged to follow up with local media and make the public aware of this proposal.

Below is the Home Care Alliance’s statement:

President Proposes Home Health Copays to Help Reduce Federal Deficit

Industry Calls Copayments an Inappropriate Burden and a Tax on Most Vulnerable Elders

Boston, MA – With the debate over the federal budget debt ceiling heating up, the Home Care Alliance of Massachusetts has joined organizations from across the nation in vehement opposition to President Barack Obama’s proposal to impose co-payments for Medicare Home Health Services.

What began as a recommendation to Congress by the Medicare Payment Advisory Committee (MEDPAC) is now entrenched in discussions over how the country will raise revenues and reduce spending.

“It has been shown in many studies that copayments are an inefficient and regressive ‘sick tax’ that falls most heavily on the poorest and oldest Medicare beneficiaries,” said Patricia M. Kelleher, the Executive Director of the Home Care Alliance of Massachusetts. 

Congress eliminated home health copayments in 1972 as part of a Medicare modernization effort that concluded that such copayments fell disproportionately on the home health users with the highest Medicare expenses and the worst health status. Moreover, they discouraged using home health in lieu of more expensive nursing facility stays. As recently as 2003, Congress rejected a home care co-pay proposal for the same reasons.

President Obama’s proposal calls for a copayment of $100 per Medicare episode and excludes Medicare episodes immediately following a hospital stay. The measure would only apply to new beneficiaries beginning in 2017 and is estimated to save approximately $400 million over 10 years.

“Imposing of a copayment would continue an assault on the Medicare home health benefit that witnessed $39.7 billion in cuts passed by Congress last year,” said Kelleher. “Additionally, on January 1, 2011, Medicare added a new impediment to accessing services by requiring that homebound elderly and disabled patients, as well as hospice patients, will now need to have a ‘face-to-face encounter’ with a physician or nurse practitioner in order to receive home health services under Medicare.”

Most home health users are age 75 or older and in very poor health.  A Commonwealth Fund Report recently found that individuals of all incomes with fair or poor health status or age 85 and older spent almost 30 percent of their income already on uncovered medical care, primarily due to Medicare gaps, deductibles and copayments. Additional publications, including the New England Journal of Medicine, have released findings that an increase in such copayments lowers utilization and increases hospitalizations.

“Home health agencies in Massachusetts have supported aggressive efforts to slow growth of home health spending, including testifying in support of a moratorium on new agencies,” said Kelleher. “Asking patients to pay more is not the answer.”   

Return to www.thinkhomecare.org.

Join Us for Falls Prevention Awareness Day

This year’s Falls Prevention Awareness Day will be taking place from 10:00am to 12:00pm on September 22 in the Great Hall of the Massachusetts State House. The event will feature speeches by State Senator Richard Moore and Executive Office of Elder Affairs Secretary Ann Hartstein.

Once again, clinicians, community activists, state officials and honored guests will gather to raise awareness that falls are both common and costly. Efforts are in place in our state to introduce falls prevention activities across the health care continuum and into the daily lives of older adults. Join the Massachusetts Falls Prevention Coalition and our experts to help prevent falls across all settings. Presentations will be made by the VNA of Boston and other providers with falls prevention programs.

Attendance is free and there is no registration for the event. Simply RSVP to James Fuccione at HCA (jfuccione@thinkhomecare.org) or Alissa Weintraub at Mass Senior Care (aweintraub@maseniorcare.org).

The mission of the Massachusetts Falls Prevention Coalition is to promote healthy lifestyles, behaviors and strategies to reduce the incidence and severity of falls and fall related injuries across the lifespan in Massachusetts.

Return to www.thinkhomecare.org.

State Bill Filed to Expand Hospice Coverage

According to a report by State House News Service, a bill was recently filed by a group of legislators that would expand hospice coverage to about 120,000 more residents on MassHealth.

Senate Bill 1999, An Act extending hospice care to the MassHealth basic and MassHealth essential programs was filed by Senator Patricia Jehlen and seeks what its title states. Hospice coverage, according to State House News, is available to about 1 million MassHealth recipients, but not to roughly 120,000 who are on more restrictive plans known as MassHealth Basic and MassHealth Essential.

The inspiration for this bill comes from a report assembled by the Massachusetts Commission on End-Of-Life Care, which was established by the legislature in 2009 to study issues surrounding end-of-life care and how such care is provided in the state.

The Home Care Alliance applauds the initiative to expand hospice coverage so that people can fulfill their preference to receive end-of-life care in their homes. While approximately 67 percent of Massachusetts residents say they would prefer to die at home, only 24 percent actually do, according to statistics compiled by the commission, the Massachusetts chapter of AARP, and the state Department of Public Health.

The legislation has been referred to the Joint Committee on Health Care Financing and the Alliance will continue to provide updates on this proposal as it becomes available.

Return to www.thinkhomecare.org.

Advocacy Needed During August Recess to Avoid Cuts and Co-Pays

A so-called Debt Reduction Super Committee evolved out of the federal debt ceiling debate and will be charged with reducing the federal deficit over the next ten years.

Although cuts to entitlement programs and home health co-payments are on the table as options, a potential bright spot was reported this week in that US Senator John Kerry (D-MA) is among the members appointed to the Super Committee. Kerry was instrumental in getting cuts to home health reduced as part of health care reform.

Even with the work of Senator Kerry, Medicare home health payments are still taking a $39.7 billion hit over the next ten years. Additionally, CMS is proposing a 5.06% reduction in payments for calendar year 2012. Both of those points need to be raised when this committee considers even deeper cuts that could drastically impact agencies and patients.

Home health co-pays are another option that must be broadly opposed. Seniors could be forced to pay as much as $150 per 60-day episode of home health care, which would only push those who cannot afford it or unwilling to pay into costlier care.

Below are issues and materials that advocates can use to contact the Massachusetts Congressional Delegation, not just during August recess, but as the discussion of the Super Committee progresses. There are also materials and advocacy messages that can be used to urge Congressional support of other home care initiatives.

Advocates should be contacting their Congressperson, as well as Senator Kerry, to ask that they in turn urge the Super Committee to oppose home care cuts and copays.

Home Care Co-Pays & Medicare Cuts:

Support Home Health Access Protection Act:

Support Home Health Planning Improvement Act:

See a list of other issues, talking points, and messages available on the HCA Legislative Action Center. You can also compose your own message here.

Return to www.thinkhomecare.org.

 

Public Hearing on Temporary Nursing Agency Regulation

The state’s Division of Health Care Finance & Policy (DHCFP) is holding a public hearing and accepting written comments on amendments to regulations regarding temporary nursing services.

According to an official hearing notice, DHCFP is required to review and establish maximum rates that temporary nursing agencies may charge facilities annually. The proposed regulation is estimated to result in an increase of 4.13%, or $2.56 million, in aggregate provider expenditures for temporary nursing services.

It should be noted that eighteen of the 108 nursing facility rates decrease, all in Health Service Area 3 – Merrimack Valley, due to a decrease in the median reimbursement paid to permanent staff at nursing facilities in that region, according to the notice.

The hearing will take place at 10:00am on Wednesday, September 7th at DHCFP Headquarters, located at 2 Boylston St in Boston. For more info on the regulation, visit the regulation page on DHCFP’s website (See or search 114.3 CMR 45.00)

Return to www.thinkhomecare.org.

CMS Responds to Congressional Letter on MD Face-to-Face

Congressman Jim McGovern, along with the rest of the state’s Congressional Delegation, received a response to a letter sent to the Centers for Medicare and Medicaid Services (CMS) that reflected the struggles of home health providers in Massachusetts relative to the physician face-to-face encounter requirement.

Unfortunately, the response from CMS is mostly a reiteration of the reasoning behind the rule and a commitment to monitor the implementation of the policy “to ensure that there are no unintended disruptions in access to medically necessary home health care for our beneficiaries.”

For more on the Physician Face-to-Face Encounter Requirement, see previous posts on the subject.

Return to www.thinkhomecare.org.

HCA and Fred C. Church Collaborate on Promotion for WEEI Sports Radio

Thanks to Fred C. Church Insurance, the Home Care Alliance has an ad on WEEI Sports Radio (850-AM) that promotes the Alliance’s member home health agencies and especially the Home Care Accreditation Program for private pay home care agencies.

Hear the ad with the Alliance’s Associate Director Tim Burgers below, which is currently running on WEEI.

Return to www.thinkhomecare.org.

Alliance Meets with New Medicaid Director

photo of Julian HarrisThe Governor appointed a new Director of Medicaid in June and the Alliance has had the opportunity to meet with Dr. Julian Harris (pictured left) twice since he began acclimating to his new role.

HCA staff joined other advocates in a meeting that involved personal and organizational introductions to the new Director as well as a mention of a few top issues for each organization as it pertains to MassHealth activity. Prior to that, Alliance staff was among a small group of providers meeting with Health and Human Services Secretary JudyAnn Bigby and other officials on the Dual Eligibles Care Integration Project, which Dr. Harris sat in on.

According to a press release issued by the Governor’s office, Dr. Harris currently practices primary care at the Southern Jamaica Plain Community Health Center and hospitalist medicine at the Cambridge Health Alliance, both of which serve populations with high levels of participation in MassHealth and other state health programs. He is a clinical fellow on the faculty at Harvard Medical School and a senior resident in internal medicine and primary care at the Brigham and Women’s Hospital and its affiliated Southern Jamaica Plain Community Health Center. He formerly served at the World Bank, where he was charged with day-to-day management of the World Bank Institute’s AIDS program. He also worked on national health payment and delivery system reform for an international client at McKinsey & Company.

The Alliance looks forward to working with Dr. Harris on the challenges and opportunities for home care and MassHealth members.

Return to www.thinkhomecare.org.