Author: James Fuccione

Guest Post: Nicole K.

Hello everyone,

Today the Home Care Alliance of Massachusetts has graciously allowed me to guest blog on some very important regulatory issues facing home care. I am a home care nurse working in quality and compliance for one the largest home care agencies in the state. Currently, I’m a student at the Yale School of Nursing in their Nursing, Management, Policy, and Leadership program. I am completing an internship here at the Alliance and I plan to end it with a trip to the NAHC “March on Washington” conference this week.

This is a very exciting and challenging time for the industry. Home care is viewed by many as a way to safely and effectively care for people, in a financially sound way. I want to make it THE way for patient-centered care.

As the state and nation look towards care redesign in health care, home care should be at the head of the table for this conversation. Yet at the same time, proposed and enacted federal regulation will do extreme and permanent damage to home care. Currently, the certified home care industry is frantically preparing for the implementation of the Face-to-Face rule that takes effect April 1st. As Bill Dombi from NAHC stated, ” this is the most important Medicare change affecting home care in the last 20 years.”

On a positive note, one of our New England legislators, Senator Susan Collins, is actively working to propel forward a bill that would create greater access to home care for our sickest patients. These are the patients that can’t easily visit a physician’s office due to serious and chronic medical conditions. Senator Collins’ Home Health Care Planning Improvement Act of 2011 (S.227) would allow nurse practitioners and physicians assistants, among others, to order home care. While in Washington, I plan on speaking to any legislator who will listen to me about the damaging impact of the Face-to-Face regulation as well as the importance of passing Senator Collins’ bill. I have also lobbied remotely via telephone and using HCA-prepared emails and you can too. It’s quick and easy and makes you feel good after it’s completed.

Now is the time for all of us who work in home care or have loved ones who use home care to lobby our elected representatives to advocate for the preservation of home care.

Thank You!

Nicole K.

Return to www.thinkhomecare.org.

Physician Face-to-Face Encounter Update: New Q&As

The Centers for Medicare and Medicaid Services (CMS) have posted new guidance regarding the physician face-to-face requirement in order for patients to receive Medicare home health services.

Questions & Answers have been updated periodically by CMS and a new round has just been made available.

The new Q&A’s include:

Also, if you are from a home health agency and have not already done so, please comment on a national Face-to-Face Encounter Requirement Survey. Your feedback on whether the report reflects the issues your agency is facing will be instrumental in the Home Care Alliance’s advocacy and meetings with federal elected officials taking place at the end of March. You can comment on this newsfeed post or email James Fuccione at HCA.

Return to www.thinkhomecare.org.

Patrick Administration Postpones ADH Rate Cuts, Services Still in Jeopardy

Officials in Governor Deval Patrick’s Administration announced that rate cuts that would have taken effect today (Tuesday, March 15) to Adult Day Health, Adult Foster Care, and Day Habilitation Programs would be “postponed indefinitely.”

Those rate cuts amounted to a total of $10 million for the three programs, but there is still the danger of the much larger $55 million cut to Adult Day Health Services that would eliminate the “Basic” service category. A special advocacy day is planned for March 22 at the State House and any interested agencies offering Adult Day Health services are invited to attend. More information on the event is available here.

Return to www.thinkhomecare.org.

Physician Face-to-Face Encounter National Survey: Please Comment

The Home Care Alliance will be traveling to Washington DC later this month to advocate on many issues of concern, including the physician face-to-face encounter requirement set to be enforced starting April 1.

Please see this summary of results from a nationwide survey and let the Alliance know if your agency is in line with how other home health providers from across the country answered.

The survey was conducted by the National Association for Home Care & Hospice (NAHC) and is important in helping HCA shape the message that will be delivered to our Congressional delegation and other key government officials.

Return to www.thinkhomecare.org.

HCA Advocacy Notebook: Federal Advocacy, Adult Day Health, State Priorities

Join Us for Lobby Day in DC March 29

With all the major federal policy issues facing the home health industry right now, effective advocacy on the national level is more critical than ever.  The Home Care Alliance will be front and center with the National Association for Home Care & Hospice’s (NAHC) annual “March on Washington” at the end of the month, where federal advocacy on major issues will be the focus.

Some of those issues include:

  • The physician face-to-face encounter requirement,
  • Home health co-pays proposed by MedPAC,
  • Third Party Liability/Dual Eligible issues
  • Halting case mix “creep” adjustments and establishing better rebasing standards
  • Allowing NP’s and PA’s to sign home health plans of care

The Alliance will host a briefing for legislative staff from the Massachusetts Congressional Delegation and for Alliance members on Tuesday, March 29, at 12:00. This briefing will feature Congressman Jim McGovern, among other speakers, and is free for any Alliance members who wish to join us. Registration for the NAHC activities is not required as this is an independent event!  This is a great opportunity to discuss our priority concerns with legislators and their staff members.

Please contact James Fuccione at HCA if you are interested in attending or have any questions.

Adult Day Health Advocacy Day

HCA is cosponsoring an event to oppose a devastating cut to Adult Day Health Services.

This special advocacy day will take place on March 22 from 11:00am to 12:00pm in the Gardner Auditorium of the State House. The proposed $55 million cut in MassHealth Adult Day Health spending from its fiscal year 2012 budget would eliminate the “Basic” level of service on July 1, 2011.

According to the Massachusetts Adult Day Health Services Association (MADSA), this would eliminate services for most program members in the state. The organization estimates that out of 11,500 ADH participants, only about 500 are in the “complex” category.

No registration is required for the event, but please let the Alliance know if you plan on attending.

Legislation Update

The Home Care Alliance’s legislative priorities have received bill numbers and assignments to the committees who will hold public hearings on the issues. Most bills are headed to the Joint Committee on Public Health with one exception:  HCA’s home care omnibus bill, An Act Establishing Cost Avoidance Through Care at Home (CATCH), has been referred to the Joint Committee on Health Care Financing.

Stay tuned for when public hearings are announced by these committees so you can offer testimony and comments on these important issues.

HCA Advocacy Day A Success

The Home Care Alliance and State Senator Michael O. Moore hosted a very successful 2011 Home Health Care Advocacy Day at the State House yesterday that brought a great turnout of agencies and legislative staff to hear issues of importance, including HCA’s legislative priorities.

More than 60 attendees consisting of legislators, legislative staff, HCA members, government officials and partnering organizations heard a dynamic lineup of speakers. Senator Michael Moore offered welcoming remarks and touched on his experience on a home care visit seeing a telehealth patient with VNA Care Network in Worcester.

Dr. Matthew Shuster, Chief, Department of Ambulatory Geriatrics for Harvard Vanguard Medical Associates gave a great speech on the importance of home care from the physician perspective.

Judy Flynn from Partners Healthcare at Home presented how home care not only fits well into payment reform, but how the industry could represent a huge cost-savings to accountable care organizations based on the broad range of services that agencies provide.

Kathy Duckett, also from Partners, presented on the cost-efficiency and clinical effectiveness of telehealth. One patient she mentioned went from struggling to perform activities of daily living to planning trips to Alaska and Atlantic City (with a warm up stop at Foxwoods) thanks to the care she received through telehealth.

The Alliance’s Executive Director Patricia Kelleher rounded out the first part of the speaking program talking about An Act Relative to Home Health Aides, otherwise known as “nurse delegation,” and also kicked off the second part, which was a briefing for HCA Members only.

Dr. Jean M. McGuire, Assistant Secretary for Disability Policy and Programs for the state’s office of Health and Human Services spoke about the state’s activity on federal grants, pilot programs and other endeavors. Dr. McGuire mentioned how home health care fits in to those initiatives now and could possibly fit in for the future before taking questions from attendees.

After a short break, HCA members fanned out across the State House to meet with legislators and legislative staff to seek support for home health issues and legislation.

To see and hear some of the activity from Home Health Advocacy Day, visit our Facebook and YouTube pages. If you’re interested in becoming involved with the Alliance’s advocacy efforts, contact James Fuccione.

Return to www.thinkhomecare.org.

CMS Posts Updated List of High Readmission Hospitals

For home health agencies interested in the Community-Based Care Transitions Program, a new list of high readmission hospitals has been posted as of March 3rd on the CMS website.

The list itself, available here, includes the highest hospitals by state, their location, and other information on discharges. Massachusetts hospitals are listed on pages 9 and 10.

As always, more information will be released as it becomes available.

Return to www.thinkhomecare.org.

Physician Face to Face Encounter Update

The Home Care Alliance wrote an article in the Massachusetts Medical Society’s newsletter in an effort to further educate physicians on the CMS face-to-face encounter requirement. The article was written at the beginning of the year and published in the February edition of “Vital Signs,” the MMS newsletter, although much has happened since then.

With one month left until the April 1st enforcement deadline, the Alliance continues to provide updates as they become available. To that end, some new important Q&A’s have been posted on the CMS website, which are available here.

A few of the new Q&A’s are listed below:

Return to www.thinkhomecare.org.

Reminder: CMS Forum on Value-Based Purchasing

This is a reminder that the Centers for Medicare and Medicaid Services (CMS) will be hosting an “Open Door Forum“on designing a value-based purchasing program for home health agencies. The forum is intended to solicit input from all parties interested in implementing such a program.

CMS Special Open Door Forum

Designing A Home Health Value Based Purchasing Program

Thursday, February 24th from 1:30-3:00pm (Conference call only)

Value-based purchasing (VBP) is meant to link payment more directly to the quality of care provided and is along the same lines of other payment reform efforts seeking to reward providers for delivering high quality and efficient clinical care.

Section 3006 of the Affordable Care Act requires the Secretary of Health and Human Services to develop a plan to implement a value-based purchasing program for payments to home health agencies under the Medicare program.

CMS will be seeking stakeholder input on a number of topics defined in the statute including:

  • The ongoing development, selection, and modification process for measures of quality and efficiency;
  • The reporting, collection, and validation of quality data;
  • The structure of value-based payment adjustments, including the determination of thresholds or improvements in quality, the size of such payments, and the sources of funding for the value-based bonus payments;
  • Methods for the public disclosure of information on the performance of home health agencies;
  • and any other issues.

If you wish to participate on Feb 24th, dial 1-800-837-1935 – Conference ID 37941789.

More information on this and other CMS Open Door Forums is available here.

Return to www.thinkhomecare.org.

Join HCA for Home Health Care Advocacy Day

With the legislature looking hard at cost-saving measures and the Governor’s payment reform bill moving to the legislature for analysis, now is the time to get involved in the Home Care Alliance’s advocacy efforts.

This is also why this year’s Home Health Care Advocacy Day is so important.

Taking place from 10:00 am to 11:30 am on March 3 in Room 437 of the Massachusetts State House, this event will feature expert speakers touting the value of home care to legislative staff and HCA members who are ALL encouraged to attend.

Materials will be available for HCA members who wish to stop by legislative offices and relay what they heard at the briefing after the event concludes.

Registration is not required, but please contact the Alliance if you or someone from your agency plans on joining us for this important day so that we know how much materials are needed.

Return to www.thinkhomecare.org.